Naseem Qureshi

Mood disorders and complementary and alternative medicine: a literature review

Mood disorders are a major public health problem and are associated with considerable burden of disease, suicides, physical comorbidities, high economic costs, and poor quality of life. Approximately 30%–40% of patients with major depression have only a partial response to available pharmacological and psychotherapeutic interventions. Complementary and alternative medicine (CAM) has been used either alone or in combination with conventional therapies in patients with mood disorders. This review of the literature examines evidence-based data on the use of CAM in mood disorders. A search of the PubMed, Medline, Google Scholar, and Quertile databases using keywords was conducted, and relevant articles published in the English language in the peer-reviewed journals over the past two decades were retrieved. Evidence-based data suggest that light therapy, St John’s wort, Rhodiola rosea, omega-3 fatty acids, yoga, acupuncture, mindfulness therapies, exercise, sleep deprivation, and S-adenosylmethionine are effective in the treatment of mood disorders. Clinical trials of vitamin B complex, vitamin D, and methylfolate found that, while these were useful in physical illness, results were equivocal in patients with mood disorders. Studies support the adjunctive role of omega-3 fatty acids, eicosapentaenoic acid, and docosahexaenoic acid in unipolar and bipolar depression, although manic symptoms are not affected and higher doses are required in patients with resistant bipolar depression and rapid cycling. Omega-3 fatty acids are useful in pregnant women with major depression, and have no adverse effects on the fetus. Choline, inositol, 5-hydroxy-L-tryptophan, and N-acetylcysteine are effective adjuncts in bipolar patients. Dehydroepiandrosterone is effective both in bipolar depression and depression in the setting of comorbid physical disease, although doses should be titrated to avoid adverse effects. Ayurvedic and homeopathic therapies have the potential to improve symptoms of depression, although larger controlled trials are needed. Mind-body-spirit and integrative medicine approaches can be used effectively in mild to moderate depression and in treatment-resistant depression. Currently, although CAM therapies are not the primary treatment of mood disorders, level 1 evidence could emerge in the future showing that such treatments are effective.

Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia

Background and Objectives: Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. Methods : This cross-sectional study included 500 male students of three colleges (medicine, applied medical sciences and dentistry). Data were collected from 371 students using a self-administered questionnaire. Results : The overall prevalence of shisha smoking was 12.6% (8.6% shisha only and 4.0% both shisha and cigarettes). Thirty students (63.8% ) started shisha smoking at ages of 16 to 18 years. Seven students (15%) smoked shisha daily. Cafιs or restaurants were the favorite places for smoking (70.2% of students). There was a high prevalence of shisha smoking among students whose mothers had a secondary (19.1%) and higher (53.3%) education. Conclusions : There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended.

History of cupping (Hijama): a narrative review of literature

Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.

Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine

OBJECTIVEnThe use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities.nnnMETHODSnThis is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire.nnnRESULTSnThe mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products.nnnCONCLUSIONnThis preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.

Medical students' knowledge, attitude, and practice of complementary and alternative medicine: a pre-and post-exposure survey in Majmaah University, Saudi Arabia.

Background Evidently, complementary and alternative medicine (CAM) is a recognized medical practice that efficiently uses multiple treatment therapies and techniques in the prevention and management of a variety of human disorders. Many medical schools have integrated CAM curriculum in medical education system worldwide. Research in knowledge, attitude, and practice (KAP) of diverse health professionals exposed to CAM courses is important from many perspectives including improvement in KAP and teaching skills of faculty, together with capacity building and curriculum development. Objective and setting This pre- and post-design cross-sectional study aimed to assess CAM-KAP of two intakes of medical students in Majmaah University, Saudi Arabia. Methods The second-year medical students of the first (year 2012–2013) and second (year 2013–2014) intake (n=26 and 39, respectively) were selected for this study. A reliable, 16-item self-administered questionnaire was distributed among all the students for answering before and after the 48-hour CAM course. The data were analyzed using appropriate statistical test of significance. Results Medical students’ knowledge and attitude toward CAM significantly improved across some subitems of CAM questionnaire with a positive trend in the rest of its items including their views on CAM practices. Conclusion CAM course tends to have a positive impact on KAP of medical students. The preliminary results of this study call for further research with a larger sample in academic settings across the nation.

Classification of Cupping Therapy: A Tool for Modernization and Standardization

Cupping therapy is one of the oldest healing methods and practiced by ancient Chinese, Egyptians and Greeks. There are many types of cupping therapy and recently, practitioners and researchers have added more types to the practice of cupping. This research aimed to classify types of cupping to help in modernization and standardization of cupping therapy. This proposed classification of cupping therapy that might guide researchers stay organized, help them to differentiate and compare various types, raise their knowledge of cupping and precisely clarify cupping types terms and methods related to research in future. The proposed classification of cupping into six main categories will also help the field of cupping therapy in uniform training of concerned therapists.

Electronic Health Records, Electronic Prescribing and Medication Errors: A Systematic Review of Literature, 2000-2014.

Background: The electronic prescribing system, either standalone or embedded in the electronic health record, is a powerful tool in the hands of healthcare providers, as it reduces half of medication errors caused by handwritten prescribing.

Suicidal and self-injurious behavior among patients with alcohol and drug abuse.

Background Self-injurious behavior, a major public health problem globally, is linked with alcohol and drug abuse. This cross-sectional study aimed to identify the prevalence and correlates of self-harming behavior in patients with alcohol or drug abuse problems. Methods This was a one-year study that recruited a convenience sample of 736 outpatients and inpatients identified with alcohol or drug abuse, and was conducted at Al-Amal mental health hospitals in three major cities. All consecutively selected patients were interviewed on five working days for data collection on a semistructured sociodemographic form using the Columbia Suicide Severity Rating Scale Risk Assessment version. Results In addition to the socioclinical profile revealed, 50.7% of respondents reported any suicidal ideation, while 6.9% reported self-injurious behavior without intent to die. Any suicidal and self-injurious behavior was reported by 13.1% of participants. A total of 71.3% of respondents reported any recent negative activating events. In addition to any treatment history, observed correlates were hopelessness (60.7%), perceived burden on family (29.5%), refusing a safety plan (26.1%), and sexual abuse (11%). Conversely, reasons for living (64.9%), fear of death or dying due to pain and suffering (64.3%), and spirituality (92%) were largely endorsed as protective factors. There were multiple significant odds ratios (P ≤ 0.01) revealed when independent socioclinical variables were compared with dependent variables in terms of suspected risk and protective factors. In an adjusted logistic regression model, none of the independent variables contributed significantly to any suicidal and self-injurious behavior, any suicidal ideation, or protection from them (P > 0.05). Conclusion Our preliminary results suggest that there are some socioclinical correlates of any suicide ideation, suicidal and self-injurious behavior, and protection from risky behavior, but which of them contributes significantly to the risk and protective dimensions is yet to be elucidated in prospective community-based studies with larger and more diverse samples.

A Comparative Analysis of Electronic Prescribing Near Misses in King Saud Medical City, Riyadh, Saudi Arabia

Background: Anear missor close call is a medication error that happened but did not result in injury or damage to the pati ent. These medication errors (MEs) are captured and corrected before affecting the patient either fortuitously or purposefully by designed system controls imbedded in electronic health record (EHR) as well as electronic prescribing systems (EPS). Objective:This study analyzed the reported electronic prescribing near misses (NMs) in King Saud Medical City (KSMC) in Riyadh city. Methods: The ME report forms were consecutively collected over a period of one year,

Analysis of reported e-prescribing near misses in King Saud Medical City, Riyadh

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