Mohammed Othman Al-Rukban

Prevalence and pattern of alternative medicine use: the results of a household survey

BACKGROUND AND OBJECTIVES Alternative medicine (AM) encompasses all forms of therapies that fall outside the mainstream of medical practice. Its popularity is on the increase. Because previous surveys were limited and not generalizable, we estimated the prevalence, pattern and factors associated with use of AM in the community. SUBJECTS AND METHODS A multistage cluster cross-sectional household survey was conducted among Saudi residents of the Riyadh region. Data were collected in 2003 by trained interviewers from primary health care centers using a specially designed questionnaire. RESULTS Of 1408 individuals participating in the study, 39% were men. The mean (+/-SD) age for the study population was 35.5 (+/-13.9) years. Sixty-eight percent of the respondents had used AM during the last 12 months. The Holy Quran as a therapy was the most frequently used AM (50.3%), followed by honey (40.1%), black seed (39.2%) and myrrh (35.4%). The health belief model was found to be the most important determinant of AM use. Factors independently associated with AM use included perceived failure of medical treatment, the perceived success of AM, a preference for natural materials, and long appointment intervals to see physicians. CONCLUSIONS AND RECOMMENDATIONS There is a high prevalence of AM use in the Riyadh region and the most important determinant of AM use was the perceived failure of medical treatment. The study results call for intensive health education campaigns in the media addressing wrong beliefs regarding AM and modern medicine. The popularity of AM in this community should alert decision makers to look at the difficult accessibility to the health system.

Hypertension control and co-morbidities in primary health care centers in Riyadh.

BACKGROUND The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary healthcare (PHC) centers in Riyadh. METHODS A cross-sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records were selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. RESULTS Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females; the mean age was 57.2±11.1 years and 8.3% were smokers. The majority, 204 (85.7%), had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP and 129 (51.6%) had controlled diastolic BP. The most common co-morbidity was diabetes mellitus, found in 98 (38.4%), followed by dyslipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrence of hypertensive co-morbidities did not vary from other demographic characteristics. CONCLUSION This study demonstrated poor blood pressure control in the mini-clinics in PHC centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels.

A practical discussion to avoid common pitfalls when constructing multiple choice questions items

This paper is an attempt to produce a guide for improving the quality of Multiple Choice Questions (MCQs) used in undergraduate and postgraduate assessment. Multiple Choice Questions type is the most frequently used type of assessment worldwide. Well constructed, context rich MCQs have a high reliability per hour of testing. Avoidance of technical items flaws is essential to improve the validity evidence of MCQs. Technical item flaws are essentially of two types (i) related to testwiseness, (ii) related to irrelevant difficulty. A list of such flaws is presented together with discussion of each flaw and examples to facilitate learning of this paper and to make it learner friendly. This paper was designed to be interactive with self-assessment exercises followed by the key answer with explanations.