In this issue we have papers from the region and Malaysia covering various topics and a good review dealing with Vitamin D deficiency and project management in health. Naz et al., looked at pneumococcal and influenza vaccination amongst diabetics in the GCC: Exploring barriers and strategies for improvement. They stressed the alarming rise in the prevalence of diabetes mellitus (DM) within the Gulf Co-operation Council (GCC) has become a major public health concern. Respiratory infections in diabetics can result in a high morbidity and mortality rate, hence all the Arab states recommend pneumococcal and influenza vaccination for patients with diabetes. The few studies that have measured the rate of vaccination of within the GCC have consistently reported it to be poor. This is a cause for concern given the exponential rate at which diabetes is increasing within the region. The aim of this article is to highlight the importance of vaccination in diabetic patients, elaborate on the barriers faced in their promotion and propose strategies to improve vaccination rates.

Al-Ghareeb et al., did a retrospective cross-sectional study was conducted in Kuwait in one year (Jan 2020 to Jan 2021) in 50 PHC centers in five health regions in Kuwait and surveyed 446 participants (220 physicians, 226 nurses) who are working in PHC centers for at least a year and have regular contact with patients or clients by using a designed WHO self-administered questionnaire. the frequency and consequences of physical. The response rate for all staff was 89%.The highest respondent rate was from nurses (90% ) and the lowest respondent rate was from physicians(88%). The authors concluded that the results showed that the violence towards health care professionals (physicians and nurses) occur frequently and exists against physicians and nurses in Primary Health Care Centers in Kuwait . Health care workers should feel secure and confident in their working environment by reducing violence prevalence and increase job satisfaction by understanding the causes and factors that influence the increasing levels of violence. More research's is needed on occupational support provisions that reduce the risk of staff experiencing physical and psychological violence and the stress that is associated with it.

Mabrouk, et al., did a cross-sectional study, conducted in Hail, KSA from May 1 5, 2020, till October 2020 was carried out using the SPSS program. 411 adult persons lived in Ha'il region, aged 18 years and more, were the material of the present study. Most of the participants were Saudi (97%), female (69.4%), and most of them were highly educated, 76.7% knew the definition of squint, 56% knew at least one cause of strabismus, 43% knew the symptoms and the main source of information was family /friends in 27.5%.

Salti et al., did a qualitative descriptive case study describes the implementation of training workshops for enhancing nurses' skills in accurate blood pressure (BP) measurement and screening for diabetic peripheral neuropathy (DPN). Ninety nurses attended three full-day workshops conducted in Jeddah and Riyadh, Saudi Arabia and Dubai, United Arab Emirates. The workshops included learning modules on BP, DPN and diabetic foot care, a practical session on correct utilization of BP and DPN assessment tools and case study discussions. The nurses reported that the workshop was relevant to clinical practice and expanded their skills and knowledge. They believed it provided value as they received hands-on training in DPN diagnostic tools and proper BP measurement technique. The participating hospitals reported greater nurse involvement in diabetes management. The authors concluded that the continuous education of nurses on the latest recommendations and tools must be encouraged to ensure better patient outcomes. Screening tools for DPN should be incorporated in the nurse triage for diabetic patients to enable early detection of diabetic foot complications. Similar workshops can be conducted and utilized as training modules to enhance the skills of caregivers and other healthcare professionals.

Samer et al., looked at whether Gastro-esophageal reflux disease and poorly controlled asthma in pediatric population: are they linked? Effect of anti-reflex treatment. Using internet search, a comprehensive literature review was done and words such as Bronchial asthma, gastro esophageal reflux disease, Asthma; Proton pump inhibitors; were searched. The references of the relevant articles on this subject were also searched for further information. Results: Analyses of results of various studies from various parts of the world were considered and their prevalence was noted to access the correlation between asthma and GERD. Conclusion: The results of review researches indicate a relationship between gastroesophageal reflux and asthma, patients with persistent asthma should be screened for reflux and receive treatment for better control of their asthma.

Al-Shehri et al., attempted to assess the knowledge, behavior, and practice of parents regarding the tonsillectomy process for children in Aseer. Data were collected from participants using an electronic pre-structured questionnaire. The researchers developed the questionnaire by the help of field experts and after intensive literature review. Tool was reviewed using a panel of 3 experts for validation and applicability. Out of total 239 respondents the mean (SD) age of the respondents were 32.71(10.71). 65% were fathers and 35% were mothers. From the data we have observed that 15.5% of the children's of the respondents had pass through the tonsillectomy process. The authors concluded that the educational level and socioeconomic status of the parents were the key factors associated with these positive behaviors. These results indicate that conducting educational programs on tonsillectomy can be beneficial.

Al Turki, et al., presented a review on the important topic of burn wound infections. Burn wounds induce metabolic alterations that predispose the patient to various complications. Infection is the most common cause of morbidity and mortality in this population. Bacterial profile of burn wound patients is diverse, depending on timing and location of injury. Early after burning, the predominant microorganisms is gram-positive bacteria such as Staphylococcus aureus. Subsequently, the burn wound colonizes with variety of microorganisms comprising both susceptible and multi-drug resistant gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter species. This review will help in understanding the epidemiology of burn wound infection and the prevalence of highly resistant bacteria in burn wound patients. In addition, it illustrates the role of strict infection control practices in preventing the nosocomial transmission of microorganisms among burn patients, and it provide guidance for empiric antibiotic therapy to avoid unnecessary broad antibiotic usage, which will reduce mortality and morbidity related to infections and decrease incidence of multi-drug resistant organisms in burn unit.

Farooq, et al., explored the incidence of iatrogenesis due to errors by physicians, adverse drug reactions (ADRs) and unhygienic conditions in hospital environment. The main hypothesis for the present study was "higher the errors in diagnosis, prescription, and adverse reactions of drugs, higher will be the risk of Iatrogenesis". Survey research is conducted by developing questionnaire. The data is collected from 300 hospitalized and outdoor patients from hospitals of District and Tehsil Head Quarters Hospitals of BhakkarThe value of Cronbach's Alpha for 17 items of "Iatrogenesis" is .879 that ensures the strong reliability of the tool and consistency of responses; having N =300, with a mean = 55.34 and std. deviation = 12.354. The results show that respondents are well aware that their health is more at risk because of errors in Physician's diagnosis and prescription and iatrogenesis incidence is prevailing due to high dosage of drug taken; adverse reaction of drugs and unhygienic conditions of hospital environment. The authors concluded that health professionals are creating unrealistic demands for consumption of more and more medicine and medical treatment.

Alghamdi, et al., tried to assess Glycaemic Control and Dyslipidemia in type 1 diabetic patients in diabetic center Al-Baha region, Saudi Arabia.A record based descriptive cross sectional was conducted at diabetes center in Al-Baha region, located in the southern area of Saudi Arabia. The study included 225 children with type 1 DM. Children ages ranged from 1 to 21 years with mean age of 10.4 ± 3.5 years old. Exact of 120 (53.3%) diabetic children were males. Majority of the diabetic children had the diseases for 1-4 years (63.6%; 143). The authors concluded that the current study revealed that dyslipidemia is a common finding among diabetic cases including type 1 diabetes mellites. Also, there is a significant association between glycaemic control and having abnormal lipid profile especially for cholesterol and HDL.

Alshaiki, et al., Follow a cross-sectional design, this study was conducted at primary health care (PHC) centers to assess primary care physicians' knowledge and practices regarding screening for colorectal cancer (CC) in Abha City. It included 104 PHC physicians. The data collection sheet included sociodemographic data of participants and a modified form of the National Survey of Primary Care Physicians' Cancer Screening Recommendations and Practices, Colorectal and Lung Cancer Screening Questionnaire. Fecal occult blood test (FOBT) was the CC screening test most commonly recommended (76%). The authors concluded that
about two-thirds of them have poor knowledge grade regarding colorectal screening. FOBT is the CC screening test most commonly discussed and recommended by PHC physicians. Cost of screening test is the most influential regarding PHC physicians' recommendations for colorectal cancer screening. Practice grades are significantly better among those with more experience in PHC and among those who attended CME on cancer screening.

Alshammari, et al., did a cross-sectional study that was conducted via a pre-validated questionnaire and was distributed among different social media with a sample size of 394 diabetic patients. The purpose of the study is to determine the prevalence of gastroesophageal reflux disease in diabetes mellitus patients. The prevalence of diabetes mellitus was 24.6%. most participants (98.9%) had a 50% or greater chance of developing GERD. Only type of management of diabetes were found to be a significant factor in developing GERD (P value = 0.001). The authors concluded that the prevalence of GERD symptoms in diabetic patients is not uncommon, 98.9% of the participants had a 50% likelihood developing GERD. The higher the duration of DM, the lower the risk of exhibiting symptoms of GERD.

Abu Hwij & Ali looked at the role of vitamin D in the human body. They stressed that Vit D is essential for calcium and bone homeostasis, especially in children because childhood and adolescence are the most critical periods for bone development. The role of Vit D is not limited to bone health as it also has important roles in many extra-skeletal targets throughout the body, such as the muscles, immune system, and the cardiovascular system. Severe vitamin D deficiency (VDD) is a well-established cause of disease, including hypocalcemia and skeletal abnormalities (e.g., rickets). Although severe deficiency causing classic bone manifestations is now rare, many adults and children endure a subclinical VDD state that may predispose them to neurologic, cardiovascular, respiratory, and immune pathology.

Razan reviewed the issue of the use of project management technique in healthcare and public health. She stressed that the research into the factors that influence project management performance and success has been ongoing for several years, and as a result, the literature on this subject is fairly extensive. While success is a central concept in project management (PM), the literature on topics related to PM success is relatively extensive and generalist. Numerous metrics and factors affecting the success of a project are common across industries, although some are unique. The focus of public health action projects and programs is on the protection of the health of specific target groups or populations, and many of them address issues of survival. Public health projects, on the other hand, have a different focus; they are concerned with creating the conditions necessary for people to be healthy, and they are critical for population welfare. Their unique characteristics justify the need for research to develop a unique model of success factors to assist top management and project managers with planning and operational management. A model of success factors would assist in identifying, controlling, and mitigating issues that increase the likelihood of going in the wrong direction, while strengthening those that add value or increase the likelihood of succeeding. It would also be beneficial as a predictive and diagnostic tool for objectively and gradually reducing the probability of project failure, thereby assisting in project performance improvement. The success of public health projects requires a systematic approach and the application of a comprehensive set of success criteria. This article provides a concise overview of the literature on the use of project management in public health.

Abdulrazak Abyad
Chief Editor