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Editorial: Advancing Community-Oriented
Primary Care through Evidence and
Awareness
As we welcome the May issue of the
Middle East Journal of Family Medicine,
we are reminded of the essential
role family physicians play in bridging
primary care with public health
priorities. This month's issue presents
a diverse set of research contributions
that not only highlight diagnostic
and therapeutic challenges in clinical
practice, but also point to the
urgent need for health education
and community-level interventions
in the Middle East.
The feature article on zinc prescribing
in family medicine underscores the
importance of recognizing micronutrient
deficiencies that often remain undiagnosed
in everyday practice. Despite the
availability of testing, zinc deficiency
continues to be overlooked, resulting
in non-specific presentations that
delay diagnosis and treatment. The
authors emphasize the diagnostic
overlap with conditions like hypothyroidism
and vitamin deficiencies and advocate
for a more structured approach to
supplementation and monitoring.
As we push toward holistic patient
care, such insights reinforce the
value of integrative, nutrition-aware
primary care.
Another standout paper explores
the use of acarbose in patients
with chronic obstructive pulmonary
disease (COPD)-a condition deeply
linked to systemic inflammation
and metabolic disturbances. Through
a nuanced discussion on endothelial
dysfunction and the broader implications
of atherosclerosis in COPD, the
authors propose acarbose as a low-cost,
oral agent with potential to modulate
both glycemic control and systemic
inflammation. This novel approach
opens avenues for rethinking metabolic
interventions in non-diabetic populations,
especially in the context of excess
fat tissue and vascular risk in
the Middle East.
This month's issue features a critical
contribution from Nepal examining
the local adverse reactions associated
with inhaled corticosteroid (ICS)
use among patients with asthma and
COPD. In this cross-sectional study
of 138 patients, over half (58.7%)
reported at least one local side
effect-including tooth decay, throat
irritation, and oral candidiasis-with
a higher incidence among females,
illiterate individuals, and those
using higher ICS doses (200 mcg
or BID regimens).
Importantly, the study found that
self-management strategies such
as saltwater gargling, mouthwash
use, and antifungal creams were
commonly used to mitigate symptoms.
However, many patients lacked proper
education on inhaler use, underscoring
a persistent gap in patient counseling
and device technique training.
The findings emphasize the need
for patient-centered respiratory
care that goes beyond prescribing
medication-highlighting the importance
of education, follow-up, and the
use of spacers to reduce side effects.
As the burden of COPD and asthma
grows across South Asia and the
Middle East, such studies offer
practical insights for improving
medication adherence and long-term
outcomes.
The second maternal health contribution
addresses the epidemiology and management
of ectopic pregnancy at a tertiary
center in Saudi Arabia. Through
retrospective analysis, the study
identifies common risk factors such
as prior abortions and cesarean
deliveries while noting the relatively
low rates of hemodynamic instability
at presentation-a testament to improved
diagnostic capabilities. Nonetheless,
the findings call for enhanced screening,
awareness, and timely intervention
to reduce complications.
Together, these contributions shed
light on clinical practices, diagnostic
reasoning, and preventive strategies
vital for family physicians. Whether
it is optimizing micronutrient management,
rethinking pharmacologic options
in chronic disease, or closing the
gap in maternal health literacy,
the common thread is clear: evidence-based,
community-oriented care is not a
luxury-it is a necessity.
At MEJFM, we remain committed to
disseminating research that informs
practice, policy, and patient empowerment.
We encourage our readers to reflect
on the lessons offered in this issue
and to apply them in ways that enhance
care across all levels of the health
system.
Warm regards,
Dr. Abdulrazak Abyad
Editor-in-Chief
Middle East Journal of Family Medicine
Mobile: 961-3-201901
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