Mohammad Alshehri

DEEP VENOUS THROMBOSIS IN ASSIR REGION OF SAUDI ARABIA, CASE-CONTROL STUDY

In a five-year case-control study (1988 to 1993) at Assir Central Hospital (ACH), Abha (8,000 feet above sea level), Saudi Arabia, 92 of 129 patients suspected of deep venous thrombosis (DVT) were studied with ascending contrast venography (CV) (74 patients, 80.4%) or Doppler ultrasonography (DUS) (18 patients, 19.6%). Female-to-male ratio was 2.3 to 1. Age range of patients was twelve to ninety years; mean age was 44.45 yrs ±17.38 years. DVT hospital incidence was 18 per 10,000 admissions. The most common associated factors included immobilization due to chronic diseases (21.7%), trauma and surgery (19.6%), and pregnancy and oral contraceptives usage (16.3%). The most common symptom and sign were limb pain and tenderness (95.6%). Limb swelling was noted in 93.5% of patients. The left lower limb was more commonly affected than the right. There was a definite increase of DVT during the winter months. Altitude was not a contributory factor. Pulmonary embolism was the greatest complication.

Effect of yogurt and pH equivalent lemon juice on salivary flow rate in healthy volunteers - An experimental crossover study.

BACKGROUNDnXerostomia is a common clinical problem, and different medications have been tried in its management. In the present study, routine dietary products are used to assess their effect on salivary flow.nnnAIMnTo assess the efficacy of yogurt and lemon juice on increase in salivation and its comparison with that of unstimulated saliva.nnnMATERIALS AND METHODSnA total of 40 volunteers (aged 19-48) were selected. The pH of yogurt was calculated, and equivalent pH lemon juice was prepared. First, normal resting saliva was collected as baseline followed by every 1 min for 5 min. Patients were given lemon juice or yogurt and then crossed over to the other group to assess the impact of the stimulants on salivary flow from 1 to 5 min.nnnRESULTSnThe results were analyzed statistically. Comparisons between baseline saliva secretion and that by yogurt and lemon juice (using the ANOVA test) showed that there was a significant increase after treatment at the end of the experiment for both yogurt and lemon juice. However, yogurt showed a significant increase in saliva secretion compared to baseline than lemon juice.nnnCONCLUSIONSnOur findings suggest that yogurt is a potential candidate for the treatment of dry mouth.

Development of Medical Education in Saudi Arabia

This chapter examines in detail the provision of medical education in Saudi medical colleges, including an emphasis on the processes being enacted to ensure that the quality of medical training is of world-class standard. The Saudi medical colleges have adopted most of the current global trends in medical education, including the integrated and problem-based learning systems. Much more, however, needs to be done to strike a balance between basic scientific knowledge and professional practice.

A matter of degrees: The introduction of clinical doctorates to the Saudi higher education system and a comparative prospective from the American model

Recent unprecedented growth in Saudi population challenged its infrastructure and intensified demand for higher education and healthcare. In response, both the government and the private sector founded numerous colleges and universities, increasing the overall number from 8 to 49 institutions of higher education. A significant portion of the expansion has been in the health professions higher education, which also included the establishment of new teaching hospitals and other medical training facilities. As part of this growth, practice (clinical) doctorates have conspicuously made their presence felt in Saudi Arabia. The doctor of pharmacy is the first clinical doctorate that has been formally adopted as the terminal professional degree in the field. Others are in the works. Results are presented using descriptive methods. Data were collected from reviews of the literature and individual institutional websites of Saudi colleges, universities and salient governmental regulatory and national accrediting agencies. This article will introduce clinical doctorates, their status and state of implementation in the American health professions higher education system as a possible model. The article will review the current status of clinical doctorates’ implementation in Saudi Arabia. It will conclude with a recommendation for concerned stake holders, including policy makers, educators, and practitioners.

Topical ampicillin for prophylaxis against wound infection in acute appendicitis.

A total of 249 patients, undergoing appendectomy for acute appendicitis, were prospectively randomized into two groups. Group I, comprising 132 patients, received sterile normal saline irrigation to the surgical wound at closure. Alternatively, Group II included 117 patients, who received intraoperative topical ampicillin irrigation of the wound. Both groups were comparable with regard to age, sex, duration of symptoms, and severity of appendicitis. All patients additionally received preoperative systemic gentamicin and Flagyl. Wound infection occurred in 5.3% of Group I compared to only 0.9% of Group II (P<0.05). The reduction in infection rate was significant (P<0.05) in histologically proven appendicitis. We conclude that the addition of intraoperative topical ampicillin to systemic gentamicin and Flagyl augments prophylaxis against wound infection in acute appendicitis.

Communication skills courses: A plea for inclusion in the medical curriculum

Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patients relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has contributed to an increase in the number of law suits, non-adherence to medical regimens, and the tendency of patients to keep changing physicians and hospitals. Also, it has been shown that health outcome is positively affected by proper communication. This includes patients satisfaction and cooperation, decrease in treatment duration, decrease in painkillers requirements, and decrease in hospital stay. Also, it has been shown that communication skills can be taught and important changes in physicians behavior and in their communication skills have been demonstrated after courses of communication skills. Thus, many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula. We should do the same in our medical colleges in Saudi Arabia.

The status of licensed pharmacy workforce in Saudi Arabia: a 2030 economic vision perspective

BackgroundThe economy of Saudi Arabia is currently undergoing a major transformation which will have an impact on employment in the pharmacy sector. However, quantitative data characterizing the pharmacy workforce in the Kingdom are currently not available. Therefore, the aim of this study was to determine the current status of the licensed pharmacy workforce in the pharmacy field in Saudi Arabia.MethodsDescriptive statistics were performed on data from the Saudi Commission for Health Specialties (SCFHS) as of March 2017.ResultsThe labor market for pharmacists in Saudi Arabia is dominated by expatriates. Saudi nationals constitute less than 20% of the pharmacists employed in the Kingdom. The underemployment of Saudis is most evident in the largest sectors of the pharmacy field, namely, private health care establishments, community pharmacies, and pharmaceutical companies.ConclusionThere is an unmet need to train Saudi citizens as pharmacists and retain them in the workforce. Addressing this issue should become an important objective in Saudi Arabia’s Vision for 2030.

Effect of scaling and root planing with and without adjunct use of an essential-oil-based mouthwash on whole salivary interleukin-1β levels in patients with periodontal disease: A short-term follow-up study

OBJECTIVEnThe aim of the present short-term follow-up study was to assess the effect of scaling and root planing (SRP) with and without adjunct use of an essential-oil-based mouthwash (EOBM) on whole salivary interleukin (IL)-1beta (β) levels in patients with periodontal disease.nnnMETHODSnNinety individuals with periodontal disease were divided into two groups. Patients in group 1 underwent SRP and were instructed to rinse with 10 mL of an EOBM twice daily for 30 days. Patients in group 2 underwent SRP and were instructed to rinse with 10 mL of water twice daily for 30 days. Whole saliva samples were collected, and IL-1β levels were measured at baseline and after 60 days of treatment. P-values < 0.05 were considered statistically significant.nnnRESULTSnAt baseline, whole salivary IL-1β levels were comparable among patients in groups 1 (135.6 ± 13.5 μg/mL) and 2 (141.2 ± 5.4 μg/mL). After 60 days of follow-up, there is a significant decrease in whole salivary IL-1β levels among patients in group 1 (10.2 ± 6.4 μg/mL) as compared to those in group 2 (56.6 ± 10.2 μg/mL) (P < 0.01).nnnCONCLUSIONnSRP, when performed with adjunct use of an EOBM, is more effective in reducing whole salivary IL-1β levels as compared to when SRP is performed without the use of an EOBM.

Parental views on fluoride tooth brushing and its impact on oral health: A cross-sectional study.

Objective: This study aimed to describe the current use and knowledge about fluoride toothpaste and childrens oral hygiene habits among parents of Saudi children. Materials and Methods: In this cross-sectional study, the parents of children aged 7–12 years who visited the undergraduate pediatric dental clinics at the College of Dentistry in Riyadh, Saudi Arabia were interviewed. The interview included questions to assess the parents level of fluoride knowledge, the dental appearance of their children, and any general dental health concerns and practices. Results: A total of 463 parents (women 55.5%, men 44.5%) were included. Over half (60.3%) of the participants reported that they were unhappy with the appearance of their childs teeth. Only 11.5% received high fluoride knowledge scores. The additive index for the level of fluoride knowledge was significantly lower among mothers than among fathers. The majority of the parents were not able to correctly report whether the toothpaste their children used contained fluoride. Furthermore, the majority of the respondents were unaware of the benefits of fluoride in preventing dental caries. Conclusions: There is a need to enhance parental knowledge regarding high fluoride intake and its harmful consequences on childrens health. Both mothers and fathers should have higher levels of awareness regarding oral health promotion to maintain optimal oral health in their children.

Impact of scaling and root planing with adjunct essential-oil-based mouthwash usage on whole salivary IgG levels in patients with periodontal inflammation

OBJECTIVEnThe aim was to assess the effect of scaling and root planing (SRP) with and without adjunct use of an essential-oil-based-mouthwash (EOBM) on whole salivary immunoglobulin G (IgG) levels in patients with periodontal inflammation.nnnMETHODSnFifty patients with periodontal inflammation were included. Treatment wise, these patients were randomly divided into two groups. In groupxa01, patients underwent SRP and were instructed to rinse with 10 mL of an EOBM twice daily for 30 days, whereas those in groupxa02 underwent SRP and were instructed to rinse with 10 mL of water twice daily for 30 days. Whole saliva samples were collected at baseline and after 40 days of treatment. P-values < 0.05 were considered statistically significant.nnnRESULTSnAt baseline, whole salivary IgG levels were comparable among patients in groups 1 (60.5 ±xa05.5 mg/dL) and 2 (57.3 ±xa02.4 mg/dL). After 40 days of follow-up, there is a significant decrease in whole salivary IgG levels among patients in groupxa01 (7.2 ±xa02.4 mg/dL) as compared to those in groupxa02 (26.6 ±xa04.6 mg/dL) (P < 0.001).nnnCONCLUSIONSnSRP, when performed with adjunct use of an EOBM, is more effective in reducing whole salivary IgG levels as compared to when SRP is performed without adjunct use of an EOBM.