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From
the Editor
This is the eleventh issue
this year that has rich papers from the region
including Kuwait, Iraq, Saudi Arabia, Yemen,
Turkey and Libya.
Youssef H et al; tried to determine the prevalence
of depression and its association with socio-demographic
characteristics among patients attending mental
and Primary Health care clinics in Kuwait. The
authors followed a cross-sectional study in
five primary healthcare regions in Kuwait for
screening of adult consumers for depression
between Sept 2017 and Sept 2018. The data were
collected by interviewing a sample of 800( 326
male and 474 female visitors, response rate
91.4%) by using the Arabic and English version
of patient Health Questionnaire 9. Based on
the interpretation of PHQ-9 scores, it was found
that out of 800 there were 262 (32.7%) patients
had no depression, 171 (21.4%) suffered from
mild depression, 105 (13.1%) suffered from moderate
depression, 58 (7.2%) suffered from moderately
to severe depression, and 33 (4.1%) suffered
from severe depression. The authors concluded
that the prevalence rate of moderate to severe
depression among PHC patients in Kuwait was
relatively high (24.4%) and it's occurrence
was more in Kuwaiti's older than 35 years, married
,females, , working participants, low educated
individuals and having low monthly income .
They stress of training primary health care
physician in mental health illness to be able
to screen , treat when there is a need, and
appropriate referral to hospital.
Ali Qaim A et al; attempted to determine the
prevalence of cervical intraepithelial abnormality,
and invasive cervical cancer among Iraqi women.
They did a cross sectional study done in Al-Alwiyaa
Maternity Teaching Hospital, Women cancer Center.
Data was obtained from the patient records for
the years from Jan.2016-Jul.2019, information
regarding the age, cytology results of the pap
smear for each patient were taken. (2182) patient
were studied. Abnormal cervical pap smear cytology
found among 1926 (88.3%), Abnormal intraepithelial
lesion is found among 508(23.3%) of total patients,
6(0.3%) patient had unsatisfactory smear, Negative
for intraepithelial lesion and malignancy (NILM)
was found among 1418(65%), ASCUS 245(11.2%),
LISL 221(10.1%), HISL 32(1.5%), Squamous cell
carcinoma 9(0.4%), Adenocarcinoma 1(0.04%).
The mean age of patient with NILM was39.4±10.9,
ASCUS 40.5±10.8 , LISL 38.4±11.3,
HISL 44.9±12.95, squamous cell carcinoma
48±6.6. The authors concluded that higher
prevalence of cervical intraepithelial abnormality
and invasive squamous cervical cancer, was reported
in this study than the neighboring countries,
giving a clue to the argent need for the cervical
cancer screening program.
Abdulaziz S et al; tried to compare haemoglobin
A1c level in insulin pump versus multi daily
injections users for type one diabetes mellitus.
The authors collected data between May 2015
to January 2018 comparing HbA1c, lipid profile
and acute complications. Data collection was
done through electronic files. Data was analyzed
by the Statistical Package of Social Sciences
(SPSS). The independent sample't' test was used
to compare continuous variables. Chi-square
test was used to compare categorical variables.
Of 214 patients, 137 on MDI and 77 on pump were
recruited. All HbA1creadings were significantly
higher in MDI users (p<0.05). Acute complications
were higher in pump users (7.8% and 18.2%) compared
to MDI users (2.9% and 6.6%) for each hypoglycaemia
and DKA respectively. The occurrence of hypoglycaemia
and DKA in MDI and pump users were found statistically
insignificant, (p=0.155 and p=0.134) and (p=0.790
and p=0.721) respectively. The authors concluded
that patients with T1DM, HbA1c was significantly
higher in MDI users, conversely, DKA was significantly
higher in pump users. Hypoglycemia showed a
significant relation to age in MDI group. Lipid
profile was statistically insignificant.
Alsayali R.M et examined the knowledge &
attitude of first aid skills among medical and
non-medical students at Taif University. They
followed a cross-sectional study and was conducted
on convenience sample of 500 female and male
(Medical and Non-Medical). The data was gained
by validated questionnaire in a sample of 500
participants, which were randomly selected.
The mean age of the participants was 21 ±
1.5 years . 56.6% of the participants were found
to have good awareness regarding first aid and
BLS. The attitude towards first aid was very
poor and only 8% had good attitude towards it.
There was statistically significant relationship
observed between attendance to first aid course
and awareness, knowledge and practices. The
authors concluded that the attitude and skills
of the study participants were not satisfactory.
Universities need to organize an effective committee
to monitor and conduct first aid courses and
activities. Students need to realize the public
importance of such activities and make them
effectively involve in theses lifesaving procedures.
Helvaci M.R et al, tried to understand some
unknown functions of plasma triglycerides. The
study included 875 cases (505 females), totally.
Mean age increased up to the plasma triglycerides
value of 200 mg/dL, and there was an increase
of triglycerides about 7.8 mg/dL for each year
of aging. Whereas male ratio increased parallel
to the increased plasma values of triglycerides,
continuously (30.9% versus 51.2%, p<0.001).
Mean body mass indexes (BMI) were 24.6, 27.1,
29.4, 29.9, and 30.0 kg/m2 in the five groups,
respectively, and it was only normal in patients
with plasma triglycerides values lower than
60 mg/dL. The authors concluded that Plasma
triglycerides may behave as acute phase reactants
indicating disseminated endothelial damage,
inflammation, fibrosis, and eventual atherosclerosis
all over the body. Interestingly, parallel to
the increased plasma triglycerides vaues, significant
deteriorations were observed about the components
of the metabolic syndrome including mean age,
male gender, smoking, BMI, FPG, LDL, WCH, HT,
DM, COPD, CHD, and CRD.
A paper from Yemen described the characteristics
of the patients, to evaluate the outcome of
an external fixation for tibia open fracture.
The study was a retrospective study involving
92 patients who have open tibia injuries, and
underwent surgical intervention for external
fixation. There were 71(77.2%) male and 21(22.8%)
female patients and the male to female ratio
was 3.4:1. The fracture patterns were categorized
according to Gustilo open fracture classification:
There were 51(55.5%) type 3A fractures, 29(31.5%)
type 3B, and 12(13%) type 3C. Bone union was
achieved in 70(76.1%) patients and delayed union
12(13%). Mal-union was observed, in 4(4.4%)
patients. There were 2(2.2%) patients exhibited
a shortening of 2 cm and other 1(1.1%) exhibited
of 1.5 cm. Pin track infection was observed
in 7(7.6%) patients and chronic osteomyelitis
in 2(2.2%) patients. Six (6.5%) patients had
non-union.
The author concluded that external fixation
is the method of choice for the primary treatment
of tibia open fracture. However, this is a small
study in two private hospitals and larger studies
are needed.
A paper from Libya reviewed the vaping problem.
It is permeating society but many instances
of sudden death and serious lung disease have
cast doubt on the safety of the practice. Trials
are needed.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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