Anna Ali

The epidemiology of Dengue fever in Saudi Arabia: A systematic review

Dengue fever (DF) is the most serious mosquito-borne viral disease worldwide. DF is an acute febrile illness caused by Aedes aegypti and Aedes albopictus, which are endemic in certain cities of Saudi Arabia, such as Jeddah and Makkah (Mecca). An online literature search was conducted using relevant keywords to retrieve DF studies conducted in Saudi Arabia. Forty-five articles were identified initially. After screening for exclusion and retrieving full texts, a total of 10 articles were used for this review. Four studies were cross-sectional, and three observed a seroprevalence ranging from 31.7% to 56.9%, either among clinically suspected cases or among patients visiting the hospital for other reasons. Evidence extracted from risk factors and distribution studies indicated that young males are commonly affected. Fever, vomiting, thrombocytopenia and leukopoenia were the common features of the three studies related to clinical presentation of DF. One cross-sectional study concerning an educational program for DF demonstrated that a positive family history of DF, literate mothers, and age over 17 years were the predictors of a high DF knowledge score. However, the paucity of large epidemiological studies limits the generalizability of such evidence. Future studies in Saudi Arabia should focus upon the expansion of DF to other cities in the Kingdom. Larger epidemiological studies are needed for estimating the true burden and incidence of DF in the Saudi population, as they are limited to seroprevalence among clinically suspected cases and hospital-based patients.

Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries

Objective: To assess the epidemiology of attention deficit hyperactivity disorder (ADHD) in Arab countries, and identify gaps for future research. Methods: We searched PubMed from July 1978 to July 2014 and reviewed local journals with cross-referencing. The keywords we used were ADHD, diagnosis, prevalence, incidence, factor, diagnosis, rate, risk, and each of the names of the 22 Arab countries (Jordan, Egypt, Lebanon, Saudi Arabia, and so on). Studies were eligible for inclusion if they investigated the epidemiology of ADHD in any Arab country, and were published in English. The search was conducted from 2nd to 5th August 2014 in King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Results: A total of 22 articles were included in the review. Twenty studies were cross-sectional and found the prevalence of ADHD ranged between 1.3-16%, prevalence of hyperactive type ADHD between 1.4-7.8%, and the prevalence of inattention type between 2.1-2.7%. Only 2 case-control studies investigated potential risk factors. Evidence extracted from these studies shows a significant association between ADHD and male gender, previous psychiatric illness in the family, vitamin D deficiency, poor school performance, sleep problems, and nocturnal enuresis. Conclusion: The prevalence of ADHD in Arab countries is comparable to reports in North America, Africa, and other countries of the Middle East. Longitudinal studies are needed to investigate the prognosis and determinants of this condition in the Arab world.

Perception and attitude of physicians toward local generic medicines in Saudi Arabia: A questionnaire-based study

Objectives: The current study aimed to explore the knowledge, perception, and attitude of physicians toward generic medicines in Saudi Arabia. Background: The local market of generic medicine share in Saudi Arabia is low compared to global and regional statistics. The reason for this low market share and the role of physicians has not previously been investigated. The purpose of this study was to assess health practitioner level of perceived knowledge, opinions and attitudes about local generic medication, and identify factors that influence infrequency of generic prescriptions. Methods: A random sample of 231 physicians was recruited from two hospitals in Riyadh (one government one private) and 178 (77%) responded. Information on the physicians’ perceived knowledge, opinions and attitude toward local generic medication was extracted, analyzed and interpreted. Factors that influence infrequent prescription of local generic drugs were identified. Results: Among the 178 participants in the physicians’ survey, 76% and 47% reported that they are knowledgeable about the terms “generic” and “bioequivalence” respectively, while 44% reported that they are able to explain bioequivalence to their patients. Approximately 52% of physicians reported that local generics should be substituted for brands if suitable for the case, and 21.9% reported that they believe SFDA approved local generics are therapeutically equivalent to their brands. Clinical effectiveness was reported by 71.9% of physicians as the most influential factor effecting prescription of brand over local generic medication. The three independent significant predictors for infrequent prescription of local generics among physicians: Government sector employment (OR = 3.74, [95%CI 1.50–9.43]), consultant level (OR = 3.94, [95%CI 1.50–10.31]) and low level of knowledge about local generics (OR = 4.11, [95%CI 1.56–10.84]). Conclusion: The low market share of local generics medicines attributed to low prescription rates is significantly more among senior-level physicians working in governmental hospitals. Low level of knowledge about generic drugs among physicians was the strongest predictive factor for low prescription. Future bigger studies are needed to confirm these results.

Pharmacist, the pharmaceutical industry and pharmacy education in Saudi Arabia: A questionnaire-based study

Background: In Saudi Arabia there is an estimated need of more than 100,000 pharmacy graduates to cover all present sectors. The shortage of pharmacists has affected many of these sectors especially the pharmaceutical industry. The contribution of Saudi pharmacists to local pharmaceuticals industry would be extremely beneficial and important for shaping the future of the drug industry within the Kingdom. It is not clear whether future Saudi pharmacists are willing to contribute to local pharmaco-industrial fields. Methods: A cross-sectional, questionnaire-based survey was conducted on all final-year pharmacy students in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA). Results: Out of a total of 130 students registered in the final-year of the pharmacy program in KSU, 122 (93.8%) were able to complete the questionnaire. The results showed that the majority (83%) of Saudi pharmacy students indicated that they had not received practical training in the pharmaceutical companies, while only 17.2% of the students felt that they had the knowledge and the skills to work in the pharmaceutical industry after graduation. The majority of the students (66.7%) chose clinical pharmacy as their future career field while only 10.9% indicated willingness to work in a pharmaceutical industry career. Only 8.2% selected working in the pharmaceutical industry. The significant predictor of possibly choosing a career in the local drug industry is a student with a bachelor’s degree (compared to Pharm D degree) in pharmacy (OR = 2.7 [95% CI 1.1–6.3]). Conclusion: Pharmacy students who are enrolled in the capital city of Riyadh are not properly trained to play an influential role in local drug companies. As a result, their level of willingness to have a career in such important business is not promising (more among Pharm D program). Future research in other pharmacy colleges within Saudi Arabia is needed to confirm such results.

Knowledge, attitude and practice about malaria in south-western Saudi Arabia: A household-based cross-sectional survey

This study aimed to assess the level of knowledge, attitudes, and practices (KAP) concerning malaria and malaria prevention among rural populations residing in the southwestern region of Saudi Arabia. This was a household-based cross-sectional survey, using structured questionnaire that was developed and distributed among households selected randomly from 19 villages (clusters) located in a southwestern region of Saudi Arabia, north of the border with Yemen. The data collected were analyzed using SPSS version 20. A majority of respondents (98.4%) reported that they had heard about malaria, but only 21.7% reported that they had sufficient information about the disease. Surprisingly, the most popular source of information was the internet and social media (proportion responding positively in parenthesis) (25.5%), followed by family (21.7%), while information from health facilities contributed only 12.4%. A majority of respondents were aware that malaria is a communicable (89.1%) and deadly (70%) disease; however, only 30.2% of the respondents responded that malaria is a treatable disease. Almost all of the aware respondents (97.5%) were inclined to seek treatment from health facilities, and 63.2% preferred to seek treatment within 24h of presenting with symptoms. Regarding personal precautions, the most common practice adopted by respondents was indoor residual spraying IRS (47.3%), followed by anti-mosquito spraying (29.8%), mosquito bed nets (13.2%) and combined anti-mosquito sprays and nets on windows (4.7%). This KAP study did not show any statistically significant differences in KAP due to age; however the practices of preventive measures against malaria differed significantly by nationality (Saudi versus non-Saudi). We conclude that most populations living in the villages have an acceptable level of knowledge and awareness about malaria and seek timely treatment. However, the positive attitudes and practices in relation to personal protection and prevention measures against malaria require marked improvement. The obvious gap between the knowledge and practice related to malaria prevention requires innovative strategies based on local evidence that well suits the local circumstances to promote and encourage the adoption and practice of personal protective measures.

Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia

Background: Obesity in Saudi Arabia is reaching an alarming level and hence the role of primary healthcare physicians becomes a necessity. Objective: This study aims to evaluate primary health care knowledge and the training needs with respect to managing obesity in Saudi Arabia. Methods: A questionnaire based cross-sectional survey was conducted among PHCC physicians in Saudi Arabia between May and October 2014. Questionnaire consisted of three parts; demographic data, questions about basic knowledge on obesity and training needs of PHCC physician regarding obesity. Questionnaire was distributed to selected physicians and response by ordinary mail through technical supervisors in general directorates all over KSA. Data entry and analysis were s carried out using SPSS. Results: Seven Hundred and seven physicians completed the questionnaire and returned it to the investigator. General knowledge about obesity was acceptable, as most of questions were answered correctly, 83.6% of the physicians had not received any specialized course or training on obesity. Priority of training requested by physicians was psychotherapy, medications (88%), counseling on nutrition/exercise (84%), and surgical therapy (75%). The difference regarding needs for training was not significantly different in relation to gender and nationality. Conclusion: This nationwide survey found that physicians had acceptable knowledge towards the management of obesity and overweight, however, they need to have more training regarding prevention and management of obesity.

Google search trend of dengue fever in developing Countries in 203-2014. An internet based analysis

O stress plays critical roles in the pathogenesis of diabetes and heart disease. The activity of Na pump has been shown to be depressed from the membrane of erythrocyte preparations of these patients coupled with alterations in membrane protein composition. We had previously discovered that the β1 subunit of the Na pump undergoes oxidative modification by oxidative stress in vitro (β1-GSS) and this mediates Na pump inhibition. This study aims to develop and validate erythrocyte β1-GSS as an oxidative stress biomarker in the premier emerging tool for prognosis of pathophysiological oxidative stress in patients with or at risk of cardiovascular disease (CVD) and diabetes. The marker is quickly and easily tested from blood using ELISA; and could be packaged and marketed as a simple kit. The eβ1-GSS biomarker is modified in heart attack, heart failure and diabetes, and exhibits potential to predict disease progression. With further investment, the eβ1-GSS biomarker could be developed initially as a versatile CVD prognosis tool for universal pre-hospital diagnostics, CVD-severity risk-stratification, and as a Companion Diagnostic (Dx) for CVD medications. Subsequently it could be adapted for diabetes.S a major Neglected Tropical Disease (NTDs) that remains difficult to control. Its recent re-emergence in Corsica, France confirms its spread from Africa to higher latitudes. Freshwater snails are obligate hosts for development of asexual stages of the trematode that causes schistosomiasis in the tropics and subtropics. Lately, it has been reported that a Mass Drug (praziquantel) Administration (MDA) approach alone to control schistosomiasis has had little impact in curtailing transmission in endemic countries. Without a vaccine to prevent schistosomiasis and this realization that drugs alone will not deliver the global eradication of schistosomiasis, there is impetus for alternative methods to control schistosomiasis, focusing on blocking transmission in the snail. Towards this end, we adopted a molecular approach to identify mechanism(s) that underlie the snail/schistosome interaction. By using resistant and susceptible Biomphalaria glabrata snails infected with Schistosoma mansoni, differences in early gene expression in genetically resistant (BS90) and susceptible (NMRI) snails were investigated. Several genes were differentially expressed between the snail phenotypes. Among others, the stress genes encoding Hsp70 and Hsp 90 were significantly expressed in NMRI (susceptible) compared to the BS90 resistant snails. Intriguingly, snails that was resistant at room temperature when subjected to heat shock at 32oC for 3 hours were rendered susceptible. Moreover, the Hsp90 inhibitor geldenamycin rendered susceptible NMRI snails as resistant as BS90. The implications of these data within the context of global warming and the snail vector approach to reduce schistosomiasis will be discussed.C depopulation methods carried out in the name of medicine and religion for more than a millennium have undermined the genetic and intellectual endowment of the human species and have led to moral and cultural degeneration. Monasticism, the bubonic plague, the Inquisition, the Crusades, the Counter-reformation and the 1918 Spanish flu pandemic constitute a virtually uninterrupted social and scientific effort to prevent Christendom from outgrowing its food supply. With the creation of the World Health Organization (WHO) in 1948, medicine became the central agent of covert depopulation and epidemiology its primary tool.Medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. In this cross-over study involving an Italian teaching hospital we evaluated microbial contamination (total bacterial count (TBC) at 36C/22C, Staphylococcus spp., moulds, Enterococcus spp., Pseudomonas spp., E. coli, total coliform bacteria, Acinetobacter spp., and Clostridium difficile) of these devices before and after cleaning and differences in contamination between hospital units and between stethoscopes and keyboards plus handsets. We analysed 37 telephone handsets, 27 computer keyboards, and 35 stethoscopes, comparing their contamination in four hospital units. Wilcoxon signed-rank and Mann-Whitney tests were used. Before cleaning, many samples were positive for Staphylococcus spp. and coliforms. After cleaning, CFUs decreased to zero in most comparisons. The first aid unit had the highest and intensive care the lowest contamination (P < 0.01). Keyboards and handsets had higher TBC at 22C (P = 0.046) and mould contamination (P = 0.002) than stethoscopes. Healthcare professionals should disinfect stethoscopes and other possible sources of bacterial healthcare-associated infections. The cleaning technique used was effective in reducing bacterial contamination. Units with high patient turnover, such as first aid, should practise stricter hygiene.D health systems requires quality information. The basis for the management of health services are medical diagnostics. Proper and accurate coding is essential for the Colombian health system. In Colombia, whether the hospital has electronic or manual medical records, health professionals encode diagnoses without receiving training on how to do it, but by learning empirically and reproducing information biases where they learn. For this, we are working on the design and implementation of a mobile tool (app) called (CODIFICO) to develop skills in diagnoses coding by playful strategies (gamification). So students of health careers learn to codify diagnoses of diseases not by memory but by associations and pathological themed trees. So that, regardless of the type of medical records system, health professionals can, through learning and fun way, encode properly the diagnostics and this reflects in: better use of time dedicated to care, better health risk management, and at the macro system, accurate diagnosis needed to provide effective health services. It has been identified that implementation of teaching strategies through technological tools such as m-health enhance learning; this is the technical assumption of this project. We will use a methodology before-after evaluation of the quality metrics in the register of medical diagnosis and analysis of usability of the app. It is expected that by their playful nature, the app can be offered free regardless of language, in the smartphones online stores.