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From the
Editor
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This is a special double issue this year that
is rich with research papers from the region.
There is one particular paper of interested
which is the result of regional collaboration
of Middle East Primary Care Network MEPCRN.
The MEPCRN paper's aim was to determine the
prevalence of burnout, and of associated factors,
amongst family doctors (FDs) in the Middle East.
Methodology. A cross-sectional survey of FDs
was conducted using a custom-designed and validated
questionnaire which incorporated the Maslach
Burnout Inventory Human Services Survey (MBI-HSS)
as well as questions about demographic factors,
working experience, health, lifestyle and job
satisfaction. MBI-HSS scores were analysed in
the three dimensions of emotional exhaustion
(EE), depersonalization (DP) and personal accomplishment
(PA). Seven hundreds questionnaires were distributed
in 5 Midlde Eastern countries, and 500 were
returned to give a response rate of 71%. As
far as burnout, 44% of respondents scored high
for EE burnout, 30% for DP and 28% for PA, with
15% scoring high burnout in each of the three
measurements. A little more than 33% of doctors
did not score high for burnout in any dimesnion.
High burnout was observed to be emphatically
connected with a few of the variables under
concentrate, particularly those relative to
respondents' nation of home, occupation fulfillment,
expectation to change work, sick leave usage,
the misuse of liquor, tobacco and psychotropic
medication, more youthful age and male sex.
The authors conluded that burnout is by all
accounts a typical issue in FDs over the Midlde
East and is connected with individual and workload
pointers, and particularly work fulfillment,
aim to change work and the abuse of liquor,
tobacco and medicine. The study survey has all
the earmarks of being a substantial instrument
to quantify burnout in FDs. Proposals for changes
of employment conditions and future research
are needed for further exploring the issue.
A paper from Saudi Arabia tried to estimate
the prevalence of Diabetic Retinopathy among
Newly Diagnosed Type 2 Diabetes Mellitus Patients
in Abha City, Saudi Arabia. All newly diagnosed
diabetic type 2 patients attending primary health
care centers in Abha during the period of study
(39 PHCCs) were referred to ophthalmology department
in Abha General Hospital for diabetic retinopathy
screening until the required sample size was
reached. The study included 393 newly diagnosed
type 2 diabetic patients. Their age ranged between
21 and 96 years with a mean of 52.9 and standard
deviation of 11.8 years. Female patients represent
(242)61.6% of them. The prevalence of diabetic
retinopathy among newly diagnosed type 2 diabetic
patients was (13)3.3%. All of DR cases were
classified using Friedman's standards as background
or non-proliferative diabetic retinopathy. The
authors concluded that the prevalence of retinopathy
in newly diagnosed type 2 diabetes mellitus
patients was found to be relatively low in this
study compared to international studies.
A paper from Riyadh studied the effect of different
concentrations of ginger and its extracts on
kidney functions and glucose in rats. Six weeks
Wister Albino rats divided in to six groups
each had ten rats: control group (C) , diabetic
group (DC), while other groups were fed by addition
of ginger Freeze-dried or extract concentration
(0.5% - 2%) respectively (DGL, DGH, DGEL, DGEH).
Diabetes was induced by an intraperitoneal injection
of streptozotocin (50 mg/kg of body weight)
The results showed that DGH, DGEL and DGEH groups
had less weight than the two control (C, DC)
groups. The DGEL and DGEH group showed statistically
lowered food intake compared with the C and
DC group. Ginger and its extracts caused an
increase in glucose level. With regard nitrogen
blood urea (NBU) and urea, the DGL, DGEL and
DGEH groups had no significant differences when
compared with the C and DC groups. With regard
to creatinine and uric acid there were no significant
differences among all groups. This study recommends
intake of the low dose of ginger (o.5%) and
the high dose of the ginger extract (2%) for
improvement of the kidney tissue of diabetic
patients.
A paper from Yemen evaluated the prevalence
of metabolic syndrome in Yemeni patients with
hypothyroidism. A total of 350 patients with
past history or newly diagnosed hypothyroidism
(diagnosed as having high TSH, and or low FT4
and FT3 ) (patients group ) and 100 healthy
euthyroid volunteers as ( control group) attending
the outpatients medical clinics at Al-Kuwait
University hospital in Sana'a city. The patients
and control groups were under go complete history
and clinical examination included measurement
of blood pressure and waist circumference. Among
these patients 233 (66.6%) of hypothyroid patients
had subclinical and 117(33.4%) had overt hypothyroidism
. MS was significantly higher in hypothyroid
(37.4% ), (76.3%) in patients with subclinical
and 31 (23.6%) in patients with overt hypothyroidism,
than in euthyroid group (17%).The commonest
occurring metabolic syndrome defined criterion
in hypothyroid patients was central obesity
89(67.9%), high blood pressure 88 (67.1%), reduced
high density lipoprotein (61%),high serum triglyceride
(59.5%) and raised fasting blood glucose (54.9%).
The authors concluded that prevalence of MS
is high among Yemeni patients with hypothyroidism
and central obesity was the commonest co-morbidity.
These findings highlight an urgent need to develop
strategies for prevention, detection, and treatment
of MS that could contribute to decreasing the
prevalence of cardiovascular morbidity and mortality
in hypothyroid patients.
A review paper from Pakistan looked at the
Prevalence and determinants of Unintended Pregnancy.
A range of electronic databases was searched
for studies conducted in developing countries
and published between 1990 and 2015. English-language
publications were searched using relevant keywords,
and reference lists were hand searched. A systematic
review was carried out for all the quantitative
studies which met the inclusion criteria. The
quality of selected studies was assessed using
Newcastle-Ottawa Scale. Twenty-two papers were
included in the review. Average prevalence of
unintended pregnancy was estimated to be 35%
ranging from 13% to 82%. The predictors of unintended
pregnancy were found to be, socio-demographic
factors include women's age, women's education,
parity, birth order and interval, previous pregnancy
intention, age at the time of marriage, socioeconomic
status, marital status, religion, caste, and
ethnicity. The authors concluded that the main
correlates were found to be age, parity, educational
and economic status. This means that undertaking
outreach in poor countries might be helpful
in fulfilling the needs of Family planning for
these women. Furthermore, community-based distribution
of family planning methods or counseling should
be targeted to the illiterate older aged women
of reproductive age with poor socioeconomic
status.
In the special education section , a surgical
education on anal abscess and fistula focused
on the general practitioner approach in term
of diagnosis, office surgery, when to refer,
and what underlying conditions to look for.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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