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From
the Editor
..........................................................................................................................
Abdul Abyad,
MD, MPH, MBA, AGSF, AFCHSE (Chief Editor)
Address correspondence
to:
Abdul Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor)
Abyad Medical Center & Middle East Longevity
Institute
Azmi Street, Abdo Center, 2nd Floor
PO BOX 618, Tripoli LEBANON
Tel & Fax: 961 6 443684/5/6
Email: aabyad@cyberia.net.lb
Web: www.amc-lb.com
.........................................................................................................................
This is the second issue this year and I would
like to point out that MEJFM had 2.5 million
readers in 2008 - thank you to all our readers
for your ongoing support.
In this issue we are starting a continuing
educational supplement on TB will run in the
next few editions of the MEJFM. It was written
for the Nepal CME Program / Volume 7 / Infectious
diseases and will be free to air in the next
and subsequent issues of the Middle East Journal
of Family Medicine, due to great regional need
for quality education on the topic. QA&CPD
is the highest world standard medical education
and the only educational format that has proven
educational outcomes for practising doctors,
and those wishing to use the education formally
can request the additional evaluation module,
also available free.
The education was written/developed late in
2008 by a team of TB experts and medical educators
working in the field of TB, in the region, for
the Nick Simons Institute and World CME. We
thank the Nick Simons Institute and World CME,
and their authors, for this contribution to
quality regional medical education.
A paper from Saudi Arabia investigated the
causes of non-registration for antenatal care
at local PHC centers. The study involved 1,996
mothers from urban, rural and hegar (deserts
collection) areas. About two-fifths of mothers
failed to register for antenatal care at their
local PHCC for a variety of reasons. The authors
concluded that there is room for improvement
in coverage and registration at local PHCCs.
They added that the increasing role of private
health services in providing maternity care
necessitates a liaison between PHC and private
clinics with adequate feedback for proper monitoring
and evaluation of maternity care at the community
level.
A prospective study in multiple hospitals in
Jordan looked at the Incidence and Types of
Eye Injuries in Patients with Major Trauma.
Of the 190 patients with major trauma, 17 (11.2%)
patients had associated ocular injuries and
37 (19.5%) patients had a facial fracture. The
incidence of ocular injuries in patients with
major trauma is low, but considerable association
was found between eye injuries and facial fractures.
Young adults have the highest incidence of ocular
injury. The authors concluded that it is vital
that all patients with major trauma for the
face to be examined specifically for an ocular
injury.
Ammoura A M, HalasahN looked at white coat
syndrome. The authors studied 240 patients whose
details were recorded in the family practice
clinic. Patients were selected according to
the discordance in blood pressure readings (by
doctor, nurse and home measurements), during
a period of three years. Out of 240 patients,
60 patients were labeled hypertensive, (25%)
of cases, and the rest of the patients were
kept on follow up as white coat syndrome. The
authors pointed that the best way to diagnose
hypertension when in doubt about white coat
syndrome, is accomplished by using a 24-hour
ambulatory blood pressure monitor.
A paper from India looked at ACINETOBACTER
as an EMERGING NOSOCOMIAL PATHOGEN. A study
was performed of the clinical samples submitted
to the microbiology laboratory of a teaching
hospital over a period of 2 years. Out of a
total of 5,352 infected samples, 258 (4.8%)
were found to be due to Acinetobacter. The authors
concluded that multi-drug resistant Acinetobacter
nosocomial infection has emerged as an increasing
problem in intensive care units of the hospital.
The analysis of risk factors and susceptibility
pattern will be useful in understanding the
epidemiology of this organism in a hospital
setup.
A paper from Turkey looked at Prevalance of
osteoporosis among dialysis patients. A total
of 30 patients undergoing dialysis therapy were
enrolled in the study. The patients bone mineral
density was evaluated, which was measured by
left heel quantitative ultrasound before and
after the active vitamin D therapy. The blood
samples were collected for biochemical analysis
in the morning after a 12 hour fasting period
before and after the active vitamin D therapy.
The authors concluded that before the treatment
there was not a statistical difference between
the T score of the 3 groups. After the treatment
there was a statistically significant difference,
especially the T score was better after the
therapy, and in the second group PTH values
were between 120-250 pg/ml.
A second paper from turkey attempted to assess
the prevalence of Helicobacter pylori in dyspeptic
and non-dyspeptic patients, via the HpSA test,
to show short term effects of triple eradication
therapy on clinical and bacteriological recovery.
One hundred dyspeptic patients and 49 patients
complaining of other problems were included
in the study. While the incidence of H. pylori
amongst dyspeptic patients was 60%, the rate
was 34.7% in non-dyspeptic patients. The H.
pylori incidence rate amongst dyspeptic patients
was significantly high (p=0.005). H. pylori
risk in dyspeptic patients increased 2.94 fold.
This increase was statistically significant
(p=0.006). Following therapy, both groups showed
a statistically-significant reduction in symptom
scores. The success rate of the eradication
therapy was 80.5% (per protocol) . When all
patients receiving eradication therapy were
considered, the success rate was 58.9% (intention-to-treat).
The authors concluded that H. pylori infection
is prevalent amongst dyspeptic patients. H.
pylori infection should be taken into consideration
during the treatment of dyspeptic patients.
The use of the stool antigen test is effective
in diagnosis and treatment of H. pylori infection.
Finally, this year we bring an additional service
to our readers. The back issues and abstracts
of articles in the MEJFM, ME-JAA, MEJN ME-JIM
and New Paradigm Journal, will be made available
via key word search and via password access,
for all registered readers of these journals,
via the ME-HN - Middle East Health Network.
The ME-HN will also provide monthly newsletters,
journal alerts via email, free 'classifieds'
(positions wanted/vacant) and a range of discounted
goods and services. Details can be found in
this month's edition.
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