|
From
the Editor
In this issue various topics
relevant to primary health care were discussed
including HIV, elderly care, use of ACT and
safety of hydroxyurea in sickle cell disease.
Alzahrani H.M, et al, reviewed the existing
knowledge, attitude and practices of HCWs towards
HIV. A cross-sectional study was conducted in
primary health care centers in Abha and Khamis
Mushait cities of Aseer region, southwestern
Saudi Arabia. All HCWs (physicians, nurses,
lab technicians and dentists) were invited to
participate in the study. A validated self-administered
structured questionnaire was used to collect
data about HCWs’ personal and professional
characteristics; knowledge of HIV infection
and transmission; attitudes towards HIV/AIDS
patients and practices. A total of 372 HCWs
were included in the study. Out of them 23.9%
were unable to identify tattooing and ear piercing
as methods for transmission. Considerable proportion
failed to mention blood transfusion (3.8%),
unprotected sex (6.7%) and unclean needles (4.0%)
as possible methods for disease transmission.
Additionally, 36.8% of HCWs have a misconception
that kissing could transmit HIV and about misbelieved
that sharing eating and drinking utensils (23.1%),
swimming pool (18.8%) and living with AIDs patients
(17.5%) could transmit infection. Stigmatizing
attitude was detected. The authors concluded
that, poor knowledge and stigmatizing attitude
toward HIV patients are evident HCWs. Health
education programs should be adopted to improve
HCWs knowledge about transmission mode and combat
HIV stigma.
Alshamali, M.H et al; conducted a cross-sectional
study at 14 randomly selected Primary Health
Care Centers in Qatar to assess QOL and some
of its determinants among 672 Qatari aged 60
years or more. Convenience cluster sampling
technique, an Arabic structured interviewing
questionnaire were used. QOL was assessed using
an Arabic version of the WHO-BREF questionnaire
with a tested specific QOL-old add-on module.
The higher the domains and total scores, the
better the QOL. Around three quarters of males
had good to very good QOL, while nearly the
same percentage of females had fair to poor
QOL. All the elderly had from fair to very good
ADL% and most of them were in the fair/good
level for the IADL%. Social activity was significant
correlates with QOL. Gender, educational level,
income sufficiency, number of chronic diseases,
perceived general health and IADL% were the
significant predictors for the total QOL. QOL
among the participants was average. Physical
domain had the highest mean score, while the
social domain had the lowest. Gender and chronic
co-morbidities, were significant predictors
of elderly QOL.
Mojtabayi, M et al; look at the effect of Acceptance
and Commitment Therapy (ACT) on reducing depression
symptoms in people with epilepsy. This research
was semi-experimental and it contained a pre-test-post-test
and a control group at convenience which was
based on the results of Beck Depression Inventory
(BDI). A total of 30 patients having epilepsy
and depression symptoms were selected from among
the people having epilepsy and referring to
the Epilepsy Association in Tehran (2013). They
were randomly divided into two groups of experimental
(15 persons) and control (15 persons). Acceptance
and Commitment Therapy was done in 8 sessions
of 60-90 minutes in the experimental group and
the control group did not receive any interventions.
Pre-test and post-test scores were analyzed
by one-way covariance (ANCOVA) for both groups.
The results of this research showed that the
difference between the experimental and control
groups in the depression variable was significant
with the confidence interval of F = 87.433.
Moreover, the anxiety scores of the experimental
group were significantly decreased (P = 0.000)
compared to the control group. This suggests
that Acceptance and Commitment Therapy (ACT)
is effective in reducing the symptoms of depression
in people with epilepsy.
Helvaci*, M.R et al ; looked at the safety
of hydroxyurea in sickle cell diseases (SCDs).
The study was performed between March 2007 and
September 2013. The study included 337 patients
(169 females). Mean number of painful crises
per year was decreased with hydroxyurea (10.3
versus 1.7 crises per year, p<0.000). Mean
severity of painful crises was decreased, too
(7.8/10 versus 2.2/10, p<0.001). Although
body weight, hematocrit (Hct) value, and mean
corpuscular volume (MCV) increased, white blood
cell (WBC) and platelet (PLT) counts and direct
bilirubin, total bilirubin, and lactate dehydrogenase
(LDH) values of serum decreased (p<0.000
for all). We detected hepatotoxicity in 13 acute
painful crises (two females and 11 males) among
1.211 episodes, totally (1.0%). So it was significantly
higher in males (6.5% versus 1.1%, p<0.001).
All of them healed completely with withdrawal
of all of the medications but not hydroxyurea
alone. The solitary adverse effect of hydroxyurea
was bone marrow suppression with prominent anemia
in higher dosages. It was detected in seven
females (4.1%) and nine males (5.3%, p>0.05),
and they completely healed with transient withdrawal
and decreased dosages thereafter.
The authors concluded that Hydroxyurea decreases
frequency and severity of painful crises, WBC
and PLT counts, direct and total bilirubin,
and LDH values of serum, whereas it increases
body weight, Hct value, and MCV. The rare (1.0%)
and reversible hepatotoxicity during acute painful
crises may not be related with hydroxyurea alone,
and the bone marrow suppression with prominent
anemia in higher dosages may be the solitary
adverse effect of the drug.
A paper from Iran looks at the status of women
in Baluchi epics and shows that women once occupied
a higher status than perhaps they do now.
Two case studies, authored by academic teams
at the University of Melbourne, Australia have
been made available by medi+WORLD International.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
.........................................................................................................................
|
