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From
the Editor
In this issue a variety of
issues are raised by several authors from the
Region including patient safety, development
of primary health care in Qatar, and hypoglycemia,
Desouky D et al; evaluated culture of patient
safety in Saudi hospitals and improve patient
safety and quality of care through implementation
of safety systems and creating a culture of
safety. The Hospital Survey on Patient Safety
Culture questionnaire was used to identify dimensions
of patient safety culture. The survey questionnaire
was distributed on Al-Hada hospital general
hospital in Taif city, Saudi Arabia, to 300
health professionals including nurses, technicians,
managers and medical staff. The overall positive
responses from the participants ranged from
36.18-82%, where the positive responses are
more than the negative. Most of the participators
have positive responses about communication,
feedback about errors, and the procedure and
system at preventing error from happening, however
they reported that there is still a lot of patient
safety problems in hospital units. The staff
in hospital units was not enough but there is
a good cooperation between hospital units, and
they reported that the supervisor/ manager have
important role in improving patient safety.
The study calls for the need for increasing
attention to patient safety and efforts to improve
the performance and quality of service.
Ditta, M.A & Ahmed, B stressed that primary
health care plays a vital role in a nation public
health care system. The importance of an effective
and comprehensive primary health care system
is growing with increasing life expectancy and
growing chronic disease burden. We document
the recent establishment and development of
a primary health care system in the state of
Qatar. Primary health care corporation Qatar
is an arm of the ministry of public health and
is delivering safe and effective primary health
care services to the population of Qatar via
its 26 primary health care centers. The development
of primary health care services in Qatar can
be used as an example to inform development
of similar systems in nations, which lack developed
primary health care systems.
Ahmed B & Khan M.N stressed hypogylcaemia
can have multiple causes including iatrogenic
side effects of diabetic medications. Hypoglycaemia
increases morbidity and mortality in diabetic
patients. It can also adversely affect the productivity
and quality of life of patients. The authors
documented several consequences of hypoglycaemia
including increase susceptibility to cardiac
and neurological events. They recommend tailored
and structured patient education to ensure adequate
knowledge about the causes and management of
hypoglycaemia. We envisage that overtime increasing
use of continuous glucose monitoring and automatic
hypoglycaemic alerts will reduce the morbidity
and mortality burden of hypoglycaemia.
Hatroom, A.A.S investigate and compare the
treatment success of ESWL and URS for the treatment
of ureteral stones. They retrospectively identified
patients with solitary kidney complained of
ureteric stones treated with ESWL or URS in
Aden, between 2011 and 2014.
The collected parameters were: age, sex, stone
size, and stone location. The total study patients
were 90. They were 64 (71.1%) males and 26 (28.9%)
females. The symptoms were anuria + nausea +
vomiting in 80 (88.9%) patients and 10 (11.1%)
complaining of dysuria frequency and heamaturia.
The mean duration from starting symptoms was
2 ± 0.8 days. The most common side location
was lower ureter 44(48.9%).
The treatment procedure URS + DJ (double j -
ureteric stent) fixation was predominant with
70 (77.8%) while the treatment procedure DJ
+ ESWL was done for 20 (22.2%) patients.
There was a highly statistical significant difference
between the two groups of treatment procedures
related to sex (p = 0.000). In the ESWL group,
females were more than males 13(14.4%). In the
URS group, males were predominant with 57(63.3%)
(p = 0.001).
Success and stone free rate after ESWL was 85%,
while in URS group was successful in all patients
- stone-free 100% (p < 0.05). The author
concluded that URS seems to be more successful
in the treatment of ureteral stones, further
prospective studies with more patients are needed
to clarify our results.
Amin A et al carried a study to figure out
the prevalence dyslipidemia among knee osteoarthritis
patients and compare their abnormal serum lipid
components with non-exposed individuals. A total
of 60 patients with knee osteoarthritis and
60 non-exposed (without knee osteoarthritis)
individuals were studied in a prospective cohort
study that was conducted from March 2018 to
May 2019. The mean age of the patients with
knee osteoarthritis was 51.8 years. Female-to-male
ratio was 2.1:1. It was seen that dyslipidemia
increased two folds among patients with knee
osteoarthritis than the non-exposed subjects.
Patients and non-exposed subjects were significantly
different in terms of dyslipidemia prevalence
(p<0.013). Furthermore, all the lipid components
were significantly abnormal in those with knee
osteoarthritis. The authors concluded that dyslipidemia
is prevalent among knee osteoarthritis patients,
and there is a significant association between
knee osteoarthritis and high-density lipoprotein,
total cholesterol, low-density lipoprotein,
and triglyceride. Dyslipidemia prevention may
reduce the development of knee osteoarthritis
and cardiovascular comorbidities.
Helvaci MR et al, looked at smoking-induced
endothelial damage may increase plasma triglycerides.
Patients with plasma triglycerides values lower
than 60 mg/dL were collected into the first,
lower than 100 mg/dL into the second, lower
than 150 mg/dL into the third, lower than 200
mg/dL into the fourth, and 200 mg/dL and higher
into the fifth groups. The study included 669
cases (393 females), totally. Mean age increased
just up to triglycerides value of 200 mg/dL,
and there was an increase of triglycerides about
8.1 mg/dL for each year of aging up to this
value. Male ratio increased parallel to the
increased triglycerides, gradually (32.3% versus
50.0%, p<0.001). Body mass index (BMI) increased
just up to plasma triglycerides of 150 mg/dL.
Fasting plasma glucose, hypertension, diabetes
mellitus, and chronic obstructive pulmonary
disease increased parallel to the increased
triglycerides, gradually. The authors concluded
that Plasma triglycerides may actually be some
acute phase reactants indicating disseminated
endothelial damage, inflammation, fibrosis,
and eventual atherosclerosis all over the body.
There may be some significant relationships
between the plasma triglycerides and aging,
BMI, and smoking, but smoking may be particularly
important for plasma triglycerides values of
200 mg/dL and greater.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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