Journal of Family Medicine and Primary Care

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ISSN / EISSN : 2249-4863 / 2278-7135
Published by: Medknow (10.4103)
Total articles ≅ 3,480
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Jeyaraj Munusamy, Jaivinder Yadav, Rakesh Kumar, Anil Bhalla, Devi Dayal
Journal of Family Medicine and Primary Care, Volume 10, pp 2325-2330

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, SonuH Subba, BimalKumar Sahoo
Journal of Family Medicine and Primary Care, Volume 10, pp 589-594; https://doi.org/10.4103/jfmpc.jfmpc_1416_20

Abstract:
Primary health care institutions (PHCIs) are an essential foundation for the national response to COVID-19 disease in India. With the soaring number of confirmed cases, the health system is currently under unprecedented stress. In this scenario, there is a pressing need for empowering PHCIs in COVID-19 preparedness and response. The World Health Organization's (WHO) “Health system building block” approach is a classic model, which can work as a road map for the national health system in the process of empowering PHCIs against COVID-19 as well as other upcoming global and regional public health emergencies.
Samra Abouchacra, Juma Alkaabi, Satish Chandrasekhar Nair, Abdishakur Abdulla, Mazen Taha, Mohamad Milad Ismail, Mazen Askheta, Ali Elhouni, Kurady Bairy, Raghavendra Bhat, et al.
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_267_21

Abstract:
Background: Obesity is the single most burdensome lifestyle disease, which has reached epidemic proportions. This study aimed to examine the eating behavior patterns and beliefs in a group of adolescents living in the United Arab Emirates (UAE). Procedure: A questionnaire was administered to adolescents (aged 11 and 18 years) attending outpatients' clinics at governmental health facilities. Informed consent was obtained, and the questionnaire was available in English or Arabic languages. Results: In all, 36 adolescent subjects participated in our study with 12 males and 24 females. UAE nationals constituted 72% of our participants and 28% were of other ethnic backgrounds; 75% were overweight to obese with 17% normal and 8% underweight. The majority of patients were healthy with only 6 patients suffering chronic medical diseases. We uncovered that in less than half of our cohort, the decision to eat came directly from the individuals themselves, but it was more influenced by their families. Food consumption was largely in response to physical hunger with the sensation perceived in the upper abdomen by one-third and the remainder localizing it to various other areas. Excessive caloric intake with frequent meals and snacks was also reported. Our study subjects decided what to consume mainly based on what appeared appetizing, followed by availability and cravings and to a lesser extent based on health recommendations. Excessive speed of food ingestion was self-reported in the majority of participants. Moreover, almost half of the adolescents were unable to turn down food offerings from their close family members and over one-fourth were unable to refuse food from other persons. Common symptoms reported included dysphoric mood, disordered sleep, decreased energy and concentration difficulties as well as low self-esteem. Conclusion: Our study uncovered certain eating behaviors in the cohort of adolescents, which may be important in promoting weight gain. These included misconceived hunger signals, excessive frequency, amount and speed of food consumption as well as more focus on food taste, inattentiveness to cravings and a strong social influence on food intake decisions. The findings of our study aim to shed some light on the eating patterns among adolescents and encourage research to investigate eating behaviors on an expanded scale evaluating ethnic, gender and age-related differences.
Elnaz Saripour, Naghmeh A Larimi, Iran Belash, Maede Abedi, Parisa Bandari, Gohar Mousavi, Sepideh Ekhtiari, Fateme H Khademloo, Kosar Rahnamaei, Maryam Esmaeili Konari, et al.
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_2148_20

Abstract:
Background and Aims: Due to the contradictory results of previous research and the lack of a specific study to address the effective nursing interventions in the early diagnosis of cancer, the purpose of this study was to determine the effect of nursing interventions on early diagnosis of cancer. Methods: This systematic review and meta-analysis were conducted during the last 5 years from 2015 to September 30, 2020. The articles related to the nursing interventions to early diagnosis of cancer were achieved from PubMed, Cochrane Library, Embase, ISI, Scopus databases, and Google and Google Scholar search engines. Risk-ratio with a 95% confidence interval (CI) between the intervention and control groups was determined using the fixed-effect model, and the Mantel–Haenszel method and I2 showed the heterogeneity of studies. Stata V16 software was used for meta-analysis. Results: The effect of an intervention on early diagnosis of breast cancer was evaluated using mammography, clinical breast examination, and breast self-exam. A total of 300 individuals participated in the study. RR results in the intervention group showed the effectiveness of nursing interventions on breast cancer detected early in both the mammography and colonoscopy (RR, 1.18 95% CI 0.57, 1.79. P =0.00 and RR, 0.58, 95% CI 0.42, 0.75, P = 0.00, respectively). Conclusion: A variety of nursing interventions including education, consultation, patient guidance, and reminders can have a positive impact on the early detection of cancers.
Raghad Sami Aljuaid, Mohammed M Mougrabi, Aeshah Dakhel Alrabie, Nouran Khalid Althumali, Lama Humaied Alkhaldi, Waad Dhaifallah Alotaibi
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_2550_20

Abstract:
Objective: Studies assessing knowledge about rheumatic fever (RF) and rheumatic heart disease (RHD) are scarce in KSA. The aim of this study was to assess the awareness about ARF and RHD among the population at Taif city, Saudi Arabia. Methods: A cross-sectional study was done on 716 of residents of Taif city. A pre-designed questionnaire that collected data about the participants' demographic characters, their history of sore throat and medication used, participants' knowledge about cause and complications of sore throat, its relation to RHD, treatment, primary and secondary prevention of RHD. Results: 77% of the participants had a history of sore throat, of them 58.4% took antibiotics as a self-medication. A significant higher prevalence of previous history of sore throat was present among 42-50-year-old females, graduated, and those with an income above 10000 SR. Participants with an age of 18-24 years and graduated, had significantly higher percent of those who knew about: cause and complications of sore throat, sore throat is associated with heart diseases, and if treating sore throat can prevent heart disease. Females had a significantly higher percent of those who knew about: complications of sore throat, being extremely aware of that primary prevention of sore throat by using antibiotics such as penicillin and being extremely aware of secondary prevention of recurrence RF and decrease progression of RHD. Conclusion: Raising awareness about ARF and RHD through health education programs is needed.
Kapil Yadav, Sunanda Gupta, S Ramadass, Ballabgarh Teaching and Research Group, Rakesh Kumar, Harshal R Salve, Shashi Kant
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_2352_20

Abstract:
Background: Health care informatics is the scientific field that deals with the data capture, storage, retrieval, and use of biomedical data, information, and knowledge for problem solving and decision-making. The objectives of the study were to describe the web-based portals used at the Primary Health Centre (PHC) and to appraise its utilization at the local level. Methods: Various methodologies included observation of portal use, record review, interview of stakeholders using the portals. Results: Health Workers workload increased because of physical record entry and time spent for entry in web-based health information portals. Web-based portals did not have options for utilization of the data generated at the PHC level. The options of feedback and helpline were not universally available. Conclusion: Web-based portals are integral part of health system at primary healthcare level. Adequate utilization of web-based health information portals may lead to efficient provision of health services at the primary health care level.
Adel F Yasky, Alia H Zawawi
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_271_21

Abstract:
Background: Polypharmacy cannot be defined numerically due to its varied definitions, and inclusion of comorbidities aggravates the dilemma, creating challenges for the healthcare system and the patients' course of treatment. The introduction of the potentially inappropriate medication (PIM) list developed by the American Geriatrics Society (AGS) (AGS Beers Criteria®; updated in 2019) was deemed a solution. However, several risk factors are associated with PIMs, including increased emergency room visits, hospitalization and mortality, and a decline in daily activity. Differences in PIM prescription rates have been reported; however, with the recent Beers criteria update, the number of patients exposed to PIMs is expected to increase significantly due to the addition of new medications to the list. Objectives: This study aimed to describe the characteristics of PIM prescriptions for the elderly in primary care and hospital settings. Methods: Medications for elderly patients prescribed in our hospital between 2016 and 2019 were reviewed and sorted based on Beers criteria to identify patients with the most PIMs. Correlations were made between gender and facility. Results: This study included 40,168 patients (51% males). The total and average numbers of PIM per elderly patient were 260,753 and 6.5, respectively. Proton pump inhibitors were prescribed the most, followed by nonsteroidal anti-inflammatory drugs. Conclusions: We found that increasing numbers of PIMs are prescribed to the elderly in our healthcare facilities. Therefore, further recommendations from local geriatric communities and the implementation of reminders for physicians through electronic prescription systems are needed to decrease the rate of prescribed PIMs.
Ghaida H Alotaibi, Abdulrahman H Alshareef, Yasser H Alnofaiey, Ali A Milibary, Afnan K Sibyani, Raghad A Alshehri, Albatoul F Althobaiti, Rehab A Alkhawtani, Faris K Alaynayn
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_126_21

Abstract:
Aim: To determine the effect of habits, traditions, and beliefs on seizure diagnosis and provide first aid in Taif city, KSA. Methods: A cross-sectional study was conducted on 297 participants from Taif, KSA. An Arabic self-administrated electronic questionnaire was used that included different parts to collect the information from participants; characters, previous history of seizures, habits, beliefs and traditions about the seizures and first aid. Results: Most of the participants had an average level of knowledge by 20.88, 47.14 and 31.99% of the participants had a poor, average and good level of knowledge about seizures and epilepsy. 70.0% of our participants knew that seizure is a symptom associated with many diseases; 40.7% knew that hypoglycemia can cause a seizure, while 37 and 32.3% did not know seizure treatment and whether Hijama and Cupping therapy were enough to treat seizure; 26.9 and 35.4% of the participants responded by neither putting something hard on the patient's mouth nor opening the patient's mouth by force to protect him from swallowing his tongue, respectively. Only 17.2% agreed on not calling the ambulance for all seizure cases. Participants aged between 20 and 29 and single had a significant higher percent of good knowledge with no significant association between gender, income and educational level and the participant's level of knowledge. Conclusion: There is a lack of knowledge and misconceptions about aspects related to seizures among the studied participants. It is recommended to raise awareness and correct false misconceptions about providing first aid to seizure patients.
Fahad Alzahrani, Yousef Al Turki
Journal of Family Medicine and Primary Care, Volume 10; https://doi.org/10.4103/jfmpc.jfmpc_236_21

Abstract:
Background: Accurate diagnosis and management of gastroesophageal reflux disease (GERD) remain a challenge in the primary care setting. The objective was to assess GERD management's knowledge and practice and its association with the family and internal medicine residents. Methods: A cross-sectional study between January 2019 and September 2020 among the family and internal medicine residents in Riyadh, Saudi Arabia. Residents answered a self-administrated questionnaire about knowledge and practices of GERD management. Results: A total of 596 residents were included in the current study. The average age was 26.8 ± 2.1 years, and 54.5% of the residents were males. The median knowledge score was 62.5%. The majority (89.8%) of the residents were using acid suppression drugs empirically, mainly proton-pump inhibitors (75.8%), for <8-week durations (69.7%) being taken before meals (84.7%). Frequent diagnostic testing for GERD included urea breath test (50.7%), 24-hour pH-metry/24-hour pH probe (47.3%), and upper endoscopy with biopsy (40.7%). Frequent causes for referral included gastrointestinal bleeding (82.6%), weight loss/appetite loss (82.2%), and failure of therapy (78.7%). Better knowledge was associated with older age, family medicine training, better referral practices, frequent reporting of atypical symptoms, and reading recent guidelines. Conclusions: We are reporting a moderate knowledge level among a group of family and internal medicine residents trained in Riyadh hospitals. Practices were generally good with some areas that need improvement, especially diagnostic testing. There is an urgent need for educational programs that target family and internal medicine residents, such as education courses that include lectures and clinical discussions with the senior staff. Also, we suggest health care organizations in Saudi Arabia establish well-structured Saudi National GERD Guidelines.
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