I would like to start the editorial by thanking all the editorial team, the reviewers, the contributors and of course the production team for our success. We are now producing the journal at a regular rate of one issue every two months and we have papers accumulating for the coming issues. Our statistics are showing 1,420,000 hits since July 2003.

This issue of the journal is particularly rich with a number of papers discussing the same theme. In addition we are starting, with this issue, the Focus on Children section.

A series of three papers discussed satisfaction with health care, from the patient and the provider point of view. In the first paper Dr Al Eisa et al discussed Job Satisfaction of Primary Health Care Physicians at Capital Health Region, Kuwait.

In this study 95 questionnaires were distributed to all physicians working in primary health care centers, in the Capital Region during the study period. It was revealed that General Practitioners were less satisfied with the rate of pay and the amount of variety in work. Young physicians appear to need more attention. In the second paper from Abu Dhabi, on patient expectations of general practitioner care, both qualitative and quantitative methods were utilised. The former included a focus group discussion and the latter, a questionnaire survey. The survey revealed overall satisfaction with general practitioner care although dissatisfaction was expressed with a few components of the services provided by the health centre. All the respondents unanimously agreed that good doctor patient relationship is very important for the satisfaction of the patients. They were of the opinion that the doctors should be communicative, compassionate and should attend to psychological and contextual determinants of illness in addition to biomedical aspects. The third paper was from Kuwait by Dr Al-Eisa et al on Patients' Satisfaction with Primary Health Care Services at Capital Health Region, Kuwait. The study was a cross sectional survey using an Arabic language questionnaire. A convenient sample of 1250 patients attending the PHCC aged 18 years and above was included in the study. The results of the study showed that although the overall satisfaction was high, some aspect of the services showed some degree of dissatisfaction. Also, some physicians' service items need suggestions and corrective intervention. Female and young patients appear to need more attention.

A study from Turkey presented data on the syndrome of Burnout among High School Teachers in Turkey. In this study all of the high schools in the city Centrum of Sivas, Turkey were contacted for this study. A total of six hundred and ten questionnaires were distributed to the teachers, and 520 questionnaires were returned. The study concluded that Turkish teachers suffer from burnout less than that of teachers in many developed countries.

Dr Ceylan et al, presented a strategic paper on integration of cervical smear screening with family planning services in the district of Diyarbakir province of Turkey 2001.

In this issue we are starting as well a new area which is focus on children. The first of a series of educational case presentations will be presented over the next ten issues. The case this month is on meningitis. A paper by Dr Madanat et el discussed - PAEDIATRIC RETINAL DETACHMENT, IS IT A REAL CLINICAL CHALLENGE? They analyzed retrospectively 30 pediatric patients' charts (33 eyes) younger than 16 years of age who underwent surgical repair for retinal detachment consecutively between May 1998 and April 2004 at King Hussein medical hospital. In this series, paediatric retinal detachment was mainly due to trauma and was more frequent in males. Most cases were treated by pars-plana vitrectomy (PPV) and the final visual acuity was relatively poor which reflects a real clinical challenge for retinal surgeons, who require good experience and proper preparations. Prophylactic treatment of the fellow eye should be undertaken without delay in a patient with a history of non-traumatic RD.

A retrospective study by Dr Abahussain, from Saudia Arabia was conducted among expatriate workers in Al-Khobar, with the aim, a study on the prevalence of intestinal parasites among expatriate workers In Al-Khobar, Saudi Arabia. A sample of 1,019 medical files was studied. The results showed that the prevalence of parasitic infection is 31.4%. 22.3% are single infections and 9.1% with multiple infections (double and triple and quadruple). The prevalence rate found in this study was high enough to merit a spotlight on it as a problem. Health education should be increased to raise awareness in society about such health problems.

Dr Alsaeedi et al presented a comprehensive review on therapy for acute and chronic heart failure for family physicians. This review focuses on the latest advances in the management of acute and chronic heart failure in patients with left ventricular systolic dysfunction

A rare case report from Kuwait described Ethyl Malonic Aciduria Encephalopathy with Respiratory Failure and Nephrotic Syndrome.

Dr Abdulrazak Abyad
Chief Editor