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This is the third issue
of the journal for 2006. This issue is rich
with papers from the different countries
in the Middle East. There is a substantial
research need in primary care in the region.
Research is an essential prerequisite to
developing the specialty further in the
Middle East, and in developing evidence-based
practice. The Middle East Primary Care Research
Network (MEPCRN) was started two years ago
with this aim in mind. Membership of the
MEPCRN is being developed rapidly, and now
includes representatives from across the
region. Membership from individuals as well
as from networks is welcomed.
The aim of the MEPCRN
is to develop family medicine research in
the area, in particular to do the following:
- To build a primary
care research network to fulfill unmet
research needs.
- To do collaborative
research within the region, and with other
networks.
- To lobby for financial
support for research in primary care from
different organisations.
- To help in the development
of research training programmes and the
professional development of family physicians/researchers.
- To organise conferences
that deal with research in family medicine
- To establish a number
of experts from a multidisciplinary background
to act as advisors and mentors.
- To help in publication
of research studies from the region.
- To foster collaboration
between individual primary care physicians,
centres and countries within the region.
- To help in the exchange
of ideas and methodologies in the region.
The network is in the
process of completing the first study on
Frequency of Job-Related Burn-out in Family
Physicians working in General/Family Practice.
In addition MEPCRN was part of a recent
research proposal for the European-Mediterranean
cooperation. The mini website of the MEPCRN
is http://www.mejfm.com/mepcrn/index.htm.
In this issue Mansour
AA et al report on foot abnormalities in
diabetics: prevalence and predictors in
Basrha. The aim of this study was to estimate
the prevalence of diabetic foot abnormalities
among patients with type 2 DM and the predictors
of these abnormalities in Basrha. This was
a cross sectional study of patients attending
the out patient clinic of two hospitals
in Basrha (the General and the Teaching)
for the period from January to the end of
December 2005. The total number of patients
was 182 (80 males and 102 females). The
authors concluded that variables that predict
foot abnormalities include higher age, male
sex, less school achievement, longer duration
of DM, higher BMI, smoking history, low
social class, insulin use, hypertension,
heart failure and proteinuria.
A study from Jordan compared
the efficiency of local infiltration of
bupivacaine and parenteral administration
of diclofenac sodium for post tonsillectomy
pain in adults. A total of 120 patients
were studied. Pain intensity after surgery
was assessed by asking patients to express
their pain on a visual analogue scale 0
- 100 mm scale (0 mm: no pain; 100 mm :
maximum imaginable pain) . It was concluded
that pre-incisional infiltration of local
anesthetic (bupivacaine) and pre-operative
parenteral administration of an NSAID, diclofenac
sodium, were found to be equally effective
methods for treating post tonsillectomy
pain.
A study from Iran compared the pattern of
Interpersonal Relationships in University
students in Persian culture. The author
used a 24-item Interpersonal Relationship
Inventory that yielded a factorial structure
based on the 4 domains of interpersonal
relationships: family, friend, extended
(non-familiar), and personal. For the study
a total of 246 subjects were considered.
It has been found that the domain of family
relationship of interpersonal relationship
was the most dominant factor followed by
the friend relationship. Therefore interpersonal
relationship was found to be more influenced
by the family and friend relationship elements
of the ingroup structure (such as family,
parents, and friends). The results indicated
that the relationship of family factors
to the intimate relationship of young adult
university students, has greater adaptability
in the family system during adolescence.
Another study by Dr Al-Jayousi
reports on Progressive Sensorineural Hearing
Loss and its Relation with Normal Tension
Glaucoma. The study was a prospective study
that was conducted in South Shouna Hospital
(Ministry of Health- Jordan) during the
period between 2003 - 2005. The study revealed
that the association between hearing loss,
normal tension glaucoma and antiphospholipid
antibody indicates that they are part of
the autoimmune systemic process.
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A case scenario from
the University Hospital, Lewisham, London
discusses the problems of persistent otalagia.
The authors discussed common presentations,
things to look for in the history and management
of modalities.
Another study from Iraq
reported on the epidemiology of upper respiratory
tract infections among children under five
years old attending general teaching hospital.
The authors stressed that the greatest problem
for developing countries is the mortality
from ARI in children less than five years
of age. In his conclusions the authors stressed
that Pneumonia was the most common form
of ARI observed among the study cases, and
the higher frequency of ARI was observed
during December. They identified history
of LBW in infants, under nutrition, lack
of immunization, absence of breast-feeding
in the first six months of life, educational
level of parents, child history of major
or chronic disease, living in crowded quarters
and paternal smoking were observed to be
important risk factors for both development
and severity of ART. The authors recommend
strengthening of the ARI programme in order
to have its message reach the majority of
Iraqi mothers.
Dr Kamrani conducted
a study to investigate serum lipid levels
of Tehranian people. A random sample of
2000 participants aged more than 60 years
were selected by random sampling process.
In this study the author stressed that since
CVD events are increased by elevated Total
Cholesterol and LDL Cholesterol, and high
prevalence of Lipoproteinaemia in older
people in Tehran, a design and execution
of Comprehensive Geriatric assessment is
needed to reduce patients at high risk of
Cardiac events.
A study from Turkey presented
the usage frequency and type of herbal treatments.
The author stressed that alternative treatment
usage is increasing around the world although
treatment methods are becoming more modern
and more drugs are made available. The author's
aim was to to determine the incidence of
treatment with herbs, in Turkey and the
reasons for its usage. The study was carried
out with a questionnaire on the Internet
which 19022 persons, who had received preliminary
information, completed. 75.9% of those participating
in the study reported that they had used
a herbal medication at least once. The main
health problems leading to the usage of
herbal medication for their treatment was
hair loss - hair care, hemorrhoids, skin
care, peptic ulcer - gastritis and infertility.
The plants the participants were most interested
in were nettle, St. John's wort, rosemary,
garden sage and hawthorn. The main reason
for interest in herbal treatments was "hoping
to find a herbal medicine which could help
treat their condition". Nettle, oleander
and thyme were the plants most commonly
used to treat cancer patients. Turkey has
a higher rate of alternative medicine usage
than other countries where similar studies
have been conducted and comprehensive and
regular studies are required to show changes
over time.
Regular contributor,
Dr Manzoor Butt from Pakistan, highlights
local issues in 'View from Pakistan' where
he looks at some of the failures of the
current system and suggests measures to
overcome them.
We would like to invite
you to start sending your nominations for
MEJFM doctor of the Year for 2006. Our 2005
winner was Dr Javid Farouqi from Abu Dhabi,
UAE. .
The MEJFM, medi+WORLD
International and the Australia Arab Chamber
of Commerce & Industry Inc has joined
forces to secure second hand laptops for
distribution amongst the Iraqi medical establishment
in order to help in the humanitarian side
of rebuilding Iraq. medi+WORLD International
are now making their online medical education
program, www.WorldCME.com free to Iraqi
doctors. However, access to internet services
is limited with most doctors relying on
'internet cafes' for services. To improve
access and expand the delivery of the free
online medical training programs 'second
hand laptops' which would be placed in hospitals,
clinics and places where doctors gather,
are required. Distribution of the lap-tops
would be coordinated through an Iraq based
medi+WORLD International advisor who is
coordinating the provision of the training
program.Dr Bahjat Safaa, of Kirkuk Iraq,
outlines the current needs of both medical
practitioners and the people of Iraq, in
his article, Eyes of the Truth.
If you can assist in
this please contact: lesleypocock@mediworld.com.au
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