Mohamed S Al Moamary

Prevalence and characteristics of cigarette smoking among 16 to 18 years old boys and girls in Saudi Arabia

OBJECTIVE: To study the prevalence and characteristics of cigarette smoking among secondary school students (16- to 18-year-old boys and girls) in Riyadh city, Saudi Arabia. METHODS: We applied a standard two-stage, cross-sectional study design. Secondary schools for both boys and girls in Riyadh city were randomly selected using a cluster sampling method. We used the global youth tobacco survey (GYTS) tool to achieve our objectives. RESULTS: Among 1272 students (606 boys and 666 girls), the prevalence of those ever smoked cigarettes was 42.8% (55.6% of boys and 31.4% of girls). The prevalence of current smoking was 19.5% (31.2% of boys and 8.9% of girls). Despite the fact that the majority of students think smoking is harmful, most do not wish to stop smoking, and they had not tried to stop in the past year. Cigarette smoking is significantly associated with the male gender, having friends who smoke, and having parents who smoke, but is not significantly associated with the type of school attended. CONCLUSION: Smoking prevalence among secondary schools students in Saudi Arabia is high and alarming. There is a need to implement an education program about the risks of smoking and to include parents and friends as healthy models to prevent students from beginning to smoke.

The prevalence and characteristics of water-pipe smoking among high school students in Saudi Arabia

OBJECTIVEnTo identify the prevalence and predictors of the water-pipe (WP) smoking epidemic in the Kingdom of Saudi Arabia (KSA).nnnMETHODSnA cross-sectional study conducted with 16-18 year-old high school students in Riyadh, Saudi Arabia.nnnRESULTSnOf the 1272 participants, 414 (33.0%) reported having tried WP smoking. Of this group, 141 (34.1%) were female and 273 (65.9%) were male. Further, 129 (10.2%) students were current WP smokers who had used at least one rock in the past month; 20 were female (1.6%) and 120 were male (8.6%). Regarding age, 276 (68.1%) students who tried WP smoking at least once began when they were over 11 years of age, whereas 129 (31.9%) began WP smoking at or before 11 years of age. Adjusted odds ratios showed that trying WP smoking at least once was associated with smoking after the age of 11 (p=0.021, OR 7.7; CI: 1.4-43.6) and accepting water-pipes from a friend (p=0.024, OR 10.6; CI: 1.4-83.4).nnnCONCLUSIONnA high prevalence of WP smoking exists among male and female high schools students in Riyadh, KSA. WP smoking was reported to begin in early adulthood.

Predicting tobacco use among high school students by using the global youth tobacco survey in Riyadh, Saudi Arabia

OBJECTIVE: To identify the predictors that lead to cigarette smoking among high school students by utilizing the global youth tobacco survey in Riyadh, Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional study was conducted among high school students (grades 10–12) in Riyadh, KSA, between April 24, 2010, and June 16, 2010. RESULTS: The response rate of the students was 92.17%. The percentage of high school students who had previously smoked cigarettes, even just 1–2 puffs, was 43.3% overall. This behavior was more common among male students (56.4%) than females (31.3%). The prevalence of students who reported that they are currently smoking at least one cigarette in the past 30 days was 19.5% (31.3% and 8.9% for males and females, respectively). “Ever smoked” status was associated with male gender (OR = 2.88, confidence interval [CI]: 2.28–3.63), parent smoking (OR = 1.70, CI: 1.25–2.30) or other member of the household smoking (OR = 2.11, CI: 1.59–2.81) who smoked, closest friends who smoked (OR = 8.17, CI: 5.56–12.00), and lack of refusal to sell cigarettes (OR = 5.68, CI: 2.09–15.48). CONCLUSION: Several predictors of cigarette smoking among high school students were identified.

Health care utilization among chronic obstructive pulmonary disease patients and the effect of pulmonary rehabilitation.

Objective: The present study aimed to analyze the utilization of health care resources among patients with chronic obstructive pulmonary disease (COPD) and to evaluate the effect of adherence to a pulmonary rehabilitation (PR) program on the utilization of these resources. Subjects and Methods: A retrospective review of medical charts of a group of patients with COPD who were enrolled in a standard outpatient PR program at a tertiary care teaching hospital was conducted. Eligible patients were above the age of 18 years with a history of dyspnea, chronic cough and/or exposure to a disease risk factor with a postbronchodilator FEV1/FVC ratio Results: Fifty patients were referred to the PR program. The average number of emergency department visits was 1.4 ± 1.6 days, the length of stay in the hospital was 1.7 ± 3.8 days, the pulmonary clinic scheduled visits were 3.9 ± 2.2, the use of combined inhalers was 9.0 ± 3.9 canisters, the use of short-acting bronchodilator was 9.0 ± 5.6 canisters, the cumulative prednisone doses were 427.5 ± 463 mg, and the use of antibiotic courses was 3.1 ± 2.9. Of the referred patients, 27 (54%) were adherent and 23 (46%) were not. Except for the use of combined inhalers, all parameters were significantly reduced in the adherent group. In contrast, the nonadherent group had increases in use of prednisone and antibiotics (p Conclusion: There was a reduction in the utilization of health care resources among adherent patients with COPD who completed a PR program as reflected in selected pharmacological and nonpharmacological parameters.OBJECTIVEnThe present study aimed to analyze the utilization of health care resources among patients with chronic obstructive pulmonary disease (COPD) and to evaluate the effect of adherence to a pulmonary rehabilitation (PR) program on the utilization of these resources.nnnSUBJECTS AND METHODSnA retrospective review of medical charts of a group of patients with COPD who were enrolled in a standard outpatient PR program at a tertiary care teaching hospital was conducted. Eligible patients were above the age of 18 years with a history of dyspnea, chronic cough and/or exposure to a disease risk factor with a postbronchodilator FEV(1)/FVC ratio <0.7.nnnRESULTSnFifty patients were referred to the PR program. The average number of emergency department visits was 1.4 +/- 1.6 days, the length of stay in the hospital was 1.7 +/- 3.8 days, the pulmonary clinic scheduled visits were 3.9 +/- 2.2, the use of combined inhalers was 9.0 +/- 3.9 canisters, the use of short-acting bronchodilator was 9.0 +/- 5.6 canisters, the cumulative prednisone doses were 427.5 +/- 463 mg, and the use of antibiotic courses was 3.1 +/- 2.9. Of the referred patients, 27 (54%) were adherent and 23 (46%) were not. Except for the use of combined inhalers, all parameters were significantly reduced in the adherent group. In contrast, the nonadherent group had increases in use of prednisone and antibiotics (p < 0.05).nnnCONCLUSIONnThere was a reduction in the utilization of health care resources among adherent patients with COPD who completed a PR program as reflected in selected pharmacological and nonpharmacological parameters.

Unconventional therapy use among asthma patients in a tertiary care center in Riyadh, Saudi Arabia

Objectives: Unconventional therapy (UT) is a therapeutic practice of alternative and complementary medicine that is not currently considered an integral part of modern medical practice. The aim of this article is to investigate the experience of Saudi patients with UT modalities in the treatment of asthma. n Materials and Methods: We carried out a cross-sectional study of asthma patients referred to King Abdulaziz Medical City, Riyadh, Saudi Arabia, during the year 2004. Information was collected using a pre-designed questionnaire administered through interviews. n Results: Two hundred consecutive patients with a mean age of 52.3 years (±18.7) were included in this study. Sixty-nine (34.5%) of those patients used some form of UT in the previous year. There was a tendency to use UT among the older age group ( P = 0.029) and among those with longer duration of disease ( P = 0.009). However, there was no significant correlation observed between the use of UT and gender, FEV 1 , or disease control. The most commonly used form of UT was recitation of Holy Quran (9%), honey (24.5%), herbs (23.5%), cautery (12%), and blackseed (10%). There was no significant correlation between disease control and the use of modalities. n Conclusion: Unconventional therapy is frequently practiced by asthma patients in Saudi Arabia, who commonly believe that UT will lead to improvement. The lack of evidence necessitates the fostering of a national project to address the practice of UT.OBJECTIVES: Unconventional therapy (UT) is a therapeutic practice of alternative and complementary medicine that is not currently considered an integral part of modern medical practice. The aim of this article is to investigate the experience of Saudi patients with UT modalities in the treatment of asthma. MATERIALS AND METHODS: We carried out a cross-sectional study of asthma patients referred to King Abdulaziz Medical City, Riyadh, Saudi Arabia, during the year 2004. Information was collected using a pre-designed questionnaire administered through interviews. RESULTS: Two hundred consecutive patients with a mean age of 52.3 years (±18.7) were included in this study. Sixty-nine (34.5%) of those patients used some form of UT in the previous year. There was a tendency to use UT among the older age group (P = 0.029) and among those with longer duration of disease (P = 0.009). However, there was no significant correlation observed between the use of UT and gender, FEV1, or disease control. The most commonly used form of UT was recitation of Holy Quran (9%), honey (24.5%), herbs (23.5%), cautery (12%), and blackseed (10%). There was no significant correlation between disease control and the use of modalities. CONCLUSION: Unconventional therapy is frequently practiced by asthma patients in Saudi Arabia, who commonly believe that UT will lead to improvement. The lack of evidence necessitates the fostering of a national project to address the practice of UT.

Utilization and responsiveness of the asthma control test (ACT) at the initiation of therapy for patients with asthma: a randomized controlled trial

BackgroundThe aim of this study was to assess the responsiveness of the asthma control test (ACT) to detect changes at the initiation of therapy and its utilization in the initiation of asthma treatment.MethodsThis study was designed as a randomized clinical trial conducted in a primary care setting. The subjects were asthma patients who had not received controller therapy for at least two months. The patients were randomized into two groups: The Saudi Initiative for Asthma (SINA) group and the Global Initiative for Asthma (GINA) group. Treatment in the SINA group was initiated at step1 when the ACT scores ≥ 20, step 2 when the score between16-19, and step 3 when the score < 16 began at step 3. The GINA group patients were started on step 2 when they had persistent asthma symptoms or step 3 when they had severely uncontrolled disease.ResultsForty-five patients were analyzed in each group. The improvement in ACT score after treatment initiation was significantly higher when the SINA approach was used (2.9 in the SINA group compared to 1.7 in the GINA group (p = 0.04)). The improvement in FEV1 was 5.8% in the SINA group compared to 3.4% in the GINA group (p = 0.46). The number of patients who achieved asthma control at the follow-up visit and required no treatment adjustment was 33 (73.3%) in the SINA group and 27 (60%) in the GINA group (p = 0.0125).ConclusionThe ACT was responsive to change at the initiation of asthma treatment and was useful for the initiation of asthma treatment.Trial Registration numberISRCTN31998214

Spirometric reference values for healthy nonsmoking Saudi adults.

To derive prediction equations of spirometric values of healthy Saudi adults and to compare the derived equations with equations reported in selected population.

Integration of evidence based medicine into the clinical years of a medical curriculum

Teaching Evidence Based Medicine (EBM) helps medical students to develop their decision making skills based on current best evidence, especially when it is taught in a clinical context. Few medical schools integrate Evidence Based Medicine into undergraduate curriculum, and those who do so, do it at the academic years only as a standalone (classroom) teaching but not at the clinical years. The College of Medicine at King Saud bin Abdulaziz University for Health Sciences was established in January 2004. The college adopted a four-year Problem Based Learning web-based curriculum. The objective of this paper is to present our experience in the integration of the EBM in the clinical phase of the medical curriculum. We teach EBM in 3 steps: first step is teaching EBM concepts and principles, second is teaching the appraisal and search skills, and the last step is teaching it in clinical rotations. Teaching EBM at clinical years consists of 4 student-centered tutorials. In conclusion, EBM may be taught in a systematic, patient centered approach at clinical rounds. This paper could serve as a model of Evidence Based Medicine integration into the clinical phase of a medical curriculum.

Tobacco consummation: Is it still a dilemma?

Submission: 12-08-10 Accepted: 13-08-10 DOI: 10.4103/1817-1737.69103 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia students.[14] The above findings showed that tobacco prevalence among educated individuals from colleges of health sciences ranged between 13% and 20%. Based on literature from this country, the prevalence was found to be higher among less educated individuals.[15,16]

The reliability of an arabic version of the self-administered standardized chronic respiratory disease questionnaire (CRQ-SAS)

BackgroundTo produce a conceptually equivalent Arabic version to the original Self-Administered Chronic Respiratory Disease Questionnaire with standardized dyspnea domain (CRQ-SAS) and to assess its reliability.MethodsThe study was carried out in two stages: stage I which was the translation of the CRQ-SAS questionnaire from the English to the Arabic language, and stage II which represented the test-retest reliability for patients receiving usual care for COPD who were not yet admitted to the pulmonary rehabilitation program.ResultsForty five patients with stable COPD were enrolled in this study. Strong test-retest reliability was found for the four domains of the CRQ-SAS, with the intra-class correlation coefficient of 0.97 for each of the domains. The association between most parameters and the four domains of CRQ-SAS were not found to be statistically significant, as measured by Pearson correlation. The number of exacerbations was negatively correlated with the dyspnea domain (correlation = -0.36, p-value = 0.02). The disease duration was negatively correlated with the domain fatigue (correlation = -0.35, p-value = 0.02). The correlation between FEV1/FVC ratio and emotion domain was -0.30 (p-value = 0.05). The mastery domain was negatively correlated with FEV1/FVC ratio with a correlation of -0.27 with borderline statistical significance (p-value = 0.07).ConclusionThe Arabic translation of the CRQ-SAS was found to be reliable to assess the quality of life among patients with COPD.