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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
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I would like to start by announcing that the
January 2008 edition will be a special issue on
the development of Family Medicine in the region.
We would like to encourage authors to submit papers
on the special theme for January 2008.
In the Focus on Quality Section Dr Bener A &
Afifi M discussed the issue of research and policy
in the Arab World. They stressed that research
alone is no silver bullet for health development.
In our countries, health research is fragmented
where there is little communication between research
producers, users, and policy makers. It is long
debated whether policy processes run well ahead
of research-based evidence or that researchers
are not selecting the appropriate "horses
for courses". The authors attempted to answer
several important issues including how do the
medical journals constitute a crucial part of
the research process? And how could medical journals
ensure the quality of the published research as
well as the effectiveness of its peer review process?
This issue has a number of papers dealing with
metabolic disorders. A cross sectional study of
patients with diabetic foot ulcers seen in 2 hospitals
in Basrah, stressed that diabetic foot ulceration
is a serious and expensive complication with considerable
morbidity that affects up to 15% of diabetic patients
during their lifetime. Nerve conduction studies
were performed using standard protocols. The authors
concluded that clinical findings correlated with
the severity of electrophysiological changes in
patients with diabetic foot ulcers.
A second study from Kuwait looked at the Prevalence
of Metabolic Syndrome in primary Health Care.
The authors utilized a cross-sectional study of
consecutive Kuwaiti participants aged between
20-60 years during March, April, May, and June
2006. Four-hundred and ninety five participants
were interviewed in detail about their social,
demographic, socio-economic, lifestyle and health
and disease status was done by using the WHO stepwise
approach to surveillance of non communicable diseases
steps after translation to Arabic. The authors
stressed that the prevalence of metabolic syndrome
is high among Kuwaiti participants attending primary
health clinic in Kuwait. They recommended that
doctors in the primary care setting should be
aware of the five risk factors related to metabolic
syndromes with a view to offering appropriate
treatment.
A study from Jordan, on Chronic Headache, investigated
the role of the Nasal Septum Deformity in chronic
headache . A total of fifty eight patients were
studied . Twenty-five patients (43%) had headaches
preoperatively occurring at least once a month
for 1 to 10 years (mean 4.5 years). After surgery,
eighteen of the 25 patients with headaches (72%)
experienced relief of their headaches at a mean
follow-up period of 13 months. The authors concluded
that nasal septum deformity is presented as an
easily diagnosed and readily correctable cause
of chronic headache.
Immunization practices were discussed in two
papers from the region. A study from Pakistan
looked at vaccination practices and factors influencing
an expanded program of immunization in the rural
and urban areaa. A cross sectional observational
survey was conducted for a total of 440 respondents.
The authors concluded that starting immunization
of infants in urban and rural areas is satisfactory
but full immunization of infants is not as satisfactory,
especially in the rural setup and that they are
often missed in the repeated doses of vaccination.
They stressed that maternal education and occupation
are the main factors that strongly affect the
immunization of children and EPI program goals.
A second paper from Bangladesh discussed immunization
coverage among slum children. The authors attempted
to identify important effects of some selected
variables in complete child immunization coverage.
With regard to immunization coverage for the children
under age five who were still alive at the time
of the survey, the figure for full immunization
was higher (92.3%) in the higher ages (24+ months)
than the age 12-23 months (89.5%). The results
show that the partial immunization coverage among
the children is gradually decreasing when the
age of the child increases.
A study from Bangladesh discussed the issue of
rising caesarean section rate in developed countries.
The authors stressed that the steady rise in CS
rate is an emerging issue of concerned workers
in mother-child health care and a matter of international
attention. The authors stressed that unnecessary
CS has resulted in increased infection, hemorrhage,
organ damage, drug complications, prematurity,
increased neonatal illness, and longer hospitalization.
The authors stressed that national CS rates do
not reflect what is happening locally, supporting
the trend toward monitoring rates at the level
of individual hospitals or physicians.
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