Prevalence, Types and Determinants of Complementary and Alternative Medications among Health Clinic Clients

Complementary and Alternative Medicine (CAM) covers a wide range of over 100 healing approaches, philosophies and therapeutic modalities that are not provided by conventional medicine. Complementary and Alternative Medicine (CAM) covers a wide range of healing approaches not provided by conventional medicine. Objectives: The study was aimed at identifying the prevalence , types and determinants of CAM use,  sources of information about CAM that patients usually depend upon and  reasons of using CAM, Methods: : A cross-sectional survey was used to collect data from random consecutive patients attending  two PHC centres out of ten which was selected randomly in Abha city. All the patients more than 18 years attended to the clinic during two months (March & April) /2014 was included in the study. Results: The present study included 504 patients attending the PHC centres. The mean age of the participants was  47.6 ± 10.2 years. 232(46.0%)  were Males and 272(54.0%) were females. The majority of participants were Saudi ((88.7%)) and Muslims (96.4%). Most of the participants were Illiterate or school level (82.1%) and less than half of them (42.9%) had  enough family income > 10,000 SR. About three fourths of the participants were born in city, most of them were non smokers (81.9%) and about one third of them had self-perceived stress level more than 5. About one third  (36.9%) of participants reported using CAM during the 12 months preceded the study. About half of the participants used CAM due to the personal and family beliefs and because of friends advice ( 63.4% & 46.8% ) respectively. More than half of CAM users used it regularly. 58.6% of CAM users Feeling physically & psychologically better after using it and most of them did not reported any side effects after using CAM.  Conclusions: Use of CAM is prevalent among patients attending  health clinics in Abha City. CAM is commonly used by all age groups. The significant factors found to increase the likelihood of CAM use were Saudi nationality, Illiterate and the place of birth, there were a statistical significant increase  of using CAM among participants born in village. However, factors like age, gender, income, religion, smoking and perceived stress level did not prove to be statistically significant and thus did not affect CAM prevalence significantly. Most families has strong personal belief on CAM Because of the Belief that CAM builds up the body’s own defenses and promotes self-healing and has less side effects. Key words: Prevalence, Determinants, Complementary,  Alternative Medications, Client

Impact of Nutrition Education Program Based on Nutritional Assessment of Adolescent in Assiut -Egypt

Background: Adolescence is a stage of rapid changing, adequate nutrition is vital for achieving full growth probable, and any disturbance will occur in this stage may lead to various health problems. Aims: to assess the nutritional status and food habits among adolescents and evaluate the impact of the educational program in primary health care sittings. Methodology: quasi-experimental research design was used. Sample size was 350 adolescents (175 intervention group and 175 control group) attending two health facilities (urban and rural) which were selected randomly. Pre and posttest (immediate and late) interview structured questionnaire was used which included socio-demographic data, anthropometric measurements, hemoglobin level, questions regarding knowledge about nutrition and food habits. Results: more than two fifths (44.4%) of the sample was anemic. The mean body mass index was 21.09±4.6. Obesity was significantly more prevalent in female (13.4%) than male (3.4%).The knowledge scores of nutritional health was significantly better among adolescents in studied group than control group (p value= 0.00). Also their eating and consumption habits had a slightly improvement. Conclusion: After implementation of the program the Adolescents' knowledge and habits had a remarkable improvement. Keywords: Adolescent, nutrition, eating habits DOI: 10.7176/JHMN/58-0

Integration of Adolescent Health Needs Into Primary Health Care Services: Designing Care Model

Integration of the health needs of all adolescent into primary health services will package all services together which leads to better health overall. Aims: toconduct a situational analysis of adolescent health needs in Assiut governorate, assess the primary health care facilities anddevelop a design model to integrate adolescent health needs into primary health care settings and assess its effectiveness. Methodology: cross-sectional and quasi-experimental design was used.Sample size was 350 adolescents (175 study and 175 control group) attending two health facilities (urban and rural)which were selected randomly. Three questionnaires were used. Firstly, pre and posttest interview structured questionnaire was used which developed according to evidence –based questionnaires. Secondly, Health care providers’ questionnaire asked question in the same modules of adolescent’s questionnaire. Last one, questionnaireto assess PHC services’ quality as perceived by adolescents. Results: One third of adolescents had moderate level of anxiety. Half of them were suffering from various level of depression. About two thirds of them hadn’t stress.Violence attitude is lower in studied group. The knowledge scores of all modules (mental, reproductive, Nutritional health, smoking / addiction, accidents and violence)  were significantly better among adolescents in studied group than control group. The majority of health providers had high level of knowledge.There are high levels of satisfaction among adolescents of most PHC services. Conclusion: Adolescents' knowledge, habits and beliefs were mostly inadequate as regards all modules. After implementation of the program remarkable improvement were achieved in adolescents’ knowledge and practice. Keywords: Adolescent Health , Primary Services, Designing Care Mode

Prevalence and Determinants of Epilepsy among School Children in Aseer Region- KSA

Epilepsy is a heterogeneous collection of neurological conditions and syndromes characterized by recurrent, unprovoked, paroxysmal seizure activity. It is estimated that 10.5 million children under 15 years have active epilepsy, representing about 25% of the global epilepsy population.2  Of the 3.5 million people who develop epilepsy annually, 40% are younger than 15 years, and more than 80% live in developing countries.  Epilepsy is an important cause of neurological morbidity in .children. Family history of epilepsy, neonatal complications, perinatal brain damage, congenital cerebral malformations, intracranial infection, neonatal seizures, febrile seizure were found as predictors of childhood seizure disorder in many of the studies. In early onset epilepsy perinatal asphyxia, neonatal meningitis and neonatal seizure was found to be the important predictors little research has been done on childhood epilepsy in Aseer region. Greater knowledge on risk factors of epilepsy in the early years of life could help to improve understanding of epilepsy, can tell us about its prognosis and allow early intervention. Objectives: This research aimed to determine the prevalence of epilepsy among the school children and determine the risk factors associated with epilepsy Methodology: A case control study was conducted among school students aged 6 up to 18 years. Primary , preparatory and secondary schools was randomly selected in Abha and Khamis Mushait.  Results: 20 cases of epilepsy was detected among the studied group. The identified major etiologic factors of the epilepsies were cerebral trauma , febrile convulsions, A family history of epilepsy was a risk factor of the cases, and the consanguinity rate among the parents was high. Conclusion :The most important risk factors for epilepsy in this study only head trauma, febrile convulsions, consanguinity and family history of epilepsy were significant Keywords: Prevalence, Determinants, Epilepsy, children, schoo

Epidemiology of Autoimmune Diseases among Attendants of General Hospitals in Aseer region

It has long been recognized that environmental influences play an important role in the risk of developing Autoimmune disease. Defining specific pathogenic environmental mediators that may trigger the development or progression of autoimmune disease remains a focus of increasing investigative effort. Factors promoting disease may not be identical to factors that influence the severity or progression of the disorder. The cause(s) of autoimmune disorders remain largely unknown. Considerable evidence supports a role for environmental agents in inducing autoimmune disorders. OBJECTIVES: The study aims to explore the risk factors of autoimmune diseases among attendants of general hospitals in Aseer Region. Methods: case control study design was carried out  included 70  patients with multiple types of auto immune diseases attending general hospitals and primary health care centers in Abha city. They were clinically diagnosed as having autoimmune diseases. and 140 clinically free subjects , age and sex matched were included as controls. RESULTS: The present study included 70 autoimmune disease patients predominantly females (88.4%). Their mean age was 42.7 ± 12.1 years and disease duration was 11.2 ± 7.2 years. The mean age of the control group was 47.1 ± 13.6 years with no significant differences in the demographic data between the patients and control (p > 0.05). This study found no significant differences between cases with autoimmune diseases and sociodemographic characteristics. Conclusion :There is multiple determinants and risk factors affecting the occurrence of autoimmune diseases. Familial history, psychological stresses, hormonal supplementation, using hair dyes, smoking and recent vaccination were significant factors associated with autoimmune diseases. Keywords: Epidemiology, autoimmune, diseases, Aseer regio

Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4\% (n = 2515) underwent surgery for malignancy and 11.7\% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8\% (n = 3041) of patients, which was handsewn in 38.9\% (n = 1183) and stapled in 61.1\% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5\% handsewn vs 12.9\% stapled) and to undergo open surgery (54.7\% handsewn vs 36.6\% stapled). The overall anastomotic leak rate was 8.1\% (245/3041), which was similar following handsewn (7.4\%) and stapled (8.5\%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95\% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe