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The objective of this review is to determine the incidence and prevalence, clinical features, and outcomes of COVID-19 in persons with cystic fibrosis.Cystic fibrosis, predominantly a chronic respiratory illness, has long been known to be fatal with concomitant bacterial or viral infections. Consequently, the effects of COVID-19 on this protracted disease need to be understood, especially since the major manifestations affect the respiratory system. Hence, this review aims to examine the burden, clinical features, and outcomes of COVID-19 on individuals with cystic fibrosis.This review will consider studies of persons in all age groups with preexisting cystic fibrosis who are diagnosed with COVID-19 using either a polymerase chain reaction, serology, or point-of-care test for SARS-CoV-2. Eligible studies will report the incidence, prevalence, clinical features, or outcomes of COVID-19 in individuals with cystic fibrosis. Studies in community or health care settings from any geographic location will be considered.The JBI methodology for systematic reviews of prevalence and incidence will be used for this review. A methodical search for eligible studies in English (as well as available translations) in MEDLINE, Embase, Scopus, and CINAHL, and unpublished literature in Google Scholar, Dissertation Abstracts International, ProQuest Dissertations and Theses, and MedNar will be conducted from the year 2020 onwards. Studies meeting the inclusion criteria will be selected for appraisal and their methodological quality will be assessed by two independent reviewers based on study titles and abstracts, followed by full-text review focusing on sampling and statistical analysis. Data extraction will be accomplished using a standardized tool. If adequate synthesized data are obtained, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures to aid in data presentation.PROSPERO CRD42021237792.

To identify final-year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries.Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society.A multi-site cross-sectional study.A self-administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines.Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students.Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates.Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses.

Background Multimorbidity has substantial impact on the health of the individual in terms of safety, quality of life and functional ability, but little is known about it from rural areas in developing countries. Hence the present study attempted to determine the prevalence and gender difference in multimorbidity from a rural area. Methods A register based cross sectional study was done by retrieving data from the family health register of the rural health centre. Data on age, gender and all the morbidities, were collected. The most prevalent morbidities were presented as frequency and percentages, prevalence of multimorbidity were presented as dyads and triads. Multiple Logistic regression was done to find the age adjusted risk of gender on multimorbidity. Results The prevalence of multimorbidity was 16.2% (13.05–19.35).The most prevalent morbidities were hypertension, diabetes, dyslipidaemia, visual impairment and thyroid in both males and females and most common dyad was hypertension and diabetes. Conclusion In the context of lack of studies from this area, the findings of the study may help the health care providers to plan interventions. Further research has to be done to identify the risk factors of multimorbidity.

Tuberculosis management in tribal areas is a major challenge to the National Tuberculosis Elimination Program in India. There is need for culturally appropriate interventions for bridging the gaps existing in the current system. There is paucity of research in this vulnerable group; hence, a study was undertaken to determine the effect of a Short Comprehensive Multimodal Behavioural Intervention in tribal colonies of Kerala.The study used before-after design to assess the effectiveness of a Short Comprehensive Multimodal Behavioural Intervention for tuberculosis knowledge and voluntary reporting among residents of tribal colonies. The intervention included individual, small group, and large group education, with verbal, printed, and performance methods. Public-private partnership with community participation was emphasized to encourage the residents to approach public health system for managing tuberculosis.Ten tribal colonies from two districts were included with 104 participants. There was significant improvement in the proportion of participants with knowledge regarding different aspects of tuberculosis such as aetiology, symptoms, transmission, and treatment. The overall knowledge score had a significant improvement [median (range) 3.0 (0-9) to 7.0 (0-11), p 0.001] when assessed one month consequent to the intense period of group education.Short-term health behavioural intervention package appropriate for the target group, implemented with public-private partnership and community participation of trained local volunteers, proved effective in improving the knowledge regarding tuberculosis and thereby health-seeking behaviour in detection. This can be tested for scaling up, and replication in other tribal health issues.

Living with diabetes can be difficult since it can affect the patient in many ways. Diabetic foot syndrome (DFS) is described as a group of symptoms where neuropathy reduced blood supply and infection leads to tissue breakdown and morbidity.This study aims to determine the prevalence of DFS and associated sociodemographic and treatment-related factors among adults living with type 2 diabetes mellitus in a rural community.A cross-sectional study was conducted in an area under the rural health training centre of department of Community Medicine.The study was conducted to determine DFS by measuring neuropathy, peripheral vascular disease using Michigan neuropathy screening instrument, and clinical examination.The data collected was analyzed using SPSS 25.The prevalence of DFS among those with type 2 diabetes mellitus was high (51.7%). DFS was associated with advanced age (75 years), duration of diabetes for more than 5 years and with foot ulcer. Smoking and alcohol consumption were not associated with DFS.Half of those with diabetes had DFS. People with DFS were more likely to be older and living with diabetes for longer duration. This underscores the need for early identification of DFS by the primary care physicians. Further research on the role of health professionals at the primary care level in educating and screening DFS in people with diabetes are required.

Objective The objective of this review is to evaluate the effectiveness of physical stimulation on injection pain in adults receiving intramuscular injections. Introduction Intramuscular injections are the most commonly used modality for administration of pharmacological treatments. Despite this, pain from intramuscular injections is the most commonly reported side effect. Reducing patients' pain from intramuscular injections is important; however, the challenge is in selecting from the current methods available to alleviate pain, which are varied. The findings of this review may identify the most effective physical stimulation method to reduce the side effect of pain from an intramuscular injection. Inclusion criteria This review will consider studies that include adults aged 18 years and over that use physical stimulation interventions during intramuscular injections. Any physical stimulation strategies used during intramuscular injections including devices, skin tapping, manual pressure, massage, pinch, and traction will be considered. Studies that evaluate pain using validated tools such as pain scales will be included. Methods The review will undertake to find both published and unpublished studies. The key information sources to be searched are MEDLINE, Embase, CINAHL, the Cochrane Library, Cochrane Central Register of Controlled Trials, Google Scholar, Dissertation Abstracts International, ProQuest Dissertations and Theses, and MedNar. Two independent reviewers will conduct a critical appraisal of eligible studies, assess the methodological quality, and extract the data. Studies will, where possible, be pooled in a statistical meta-analysis. Systematic review registration number PROSPERO CRD42020168586.

Background: Coronavirus disease 2019 (COVID-19) pandemic has brought major changes in every sector including education. From school to college level, traditional classroom learning was forced to change to online learning. There were many challenges from inexperience to mental and physical health issues. This study aimed to find the perception of medical students about current medical online learning system in south Kerala.Methods: An online survey was conducted in November 2020 using a self-designed pretested questionnaire consisting of three sections: socio demographic profile, a 4-point Likert scale having 29 items to assess the perception of online learning, questions to assess certain parameters like health problems, duration of electronic usage etc. Frequencies, percentages, and descriptive statistics were calculated, and Chi-square test was used for statistical significance.Results: Study showed nearly three-fourth (74%) of students have a negative perception towards online learning. Of the different formats of e-learning used by students during the study period, most preferred were live lectures. Among the participants, more than half (57%) suggested a need for improvement in the quality of classes. Majority (75%) of students agreed that long hours of online classes had caused health problems.Conclusions: Though online learning is the need of the hour; majority of the students have a negative perception towards it which demands an enhancement in its standards and change to a preferred format

Context: Fall in older people is a major public health concern. Two-third of the death due to fall are preventable. Risk assessment in older adults therefore is the first step to identify the high-risk group to plan need-based intervention. Aims: The aim of the study was to determine the prevalence of risk of fall among older adults and its association with cognitive impairment and sociodemographic characteristics. Settings and Design: A cross-sectional study was conducted in the field practice areas of the department of community medicine in a teaching hospital in South Kerala, India. Subjects and Methods: A semi-structured questionnaire was used to collect the data. Berg Balance Scale and Mini-Cog Test were used for measuring risk of fall and cognitive impairment. Statistical Analysis Used: Descriptive statistics and logistic regression were used for the statistical analysis using SPSS. Results: Among the older adults, 45% were at risk of fall, 42.4% in males and 57.6% in females. The risk of fall was found to be significantly associated with cognitive impairment, (odds ratio = 3.89, confidence interval at 95% = 2.06–7.31, P < 0.001). Advanced age, female gender, and unemployed status were significantly associated with the risk of fall. Conclusions: The risk of fall prevalence was high and significantly related to cognitive impairment, advanced age, female gender, and occupational status, with more than half of those currently not working having a higher risk. The study would recommend regular follow-up of risk groups for prevention a good percentage of fall and thereby the related injuries.

Background: Quality of life is an individual’s perception of their position of life in the context of their culture and value systems in which they live and, in their goals, expectations, standards and concerns. (WHO). Though various tools to measure the generic quality of life of paediatric clients are available, a disease specific tool that is culturally adaptive to assess the quality of life of children with nephrotic syndrome is unavailable. The aim of the study was to develop a valid and reliable tool to assess the quality of life of children with nephrotic syndrome. Materials and methods: In-depth interview of twenty children with nephrotic syndrome and their mothers, review of literature and discussion with experts in health sector to formulate preliminary form of the tool. Tool is evaluated by 11 experts to ensure the content validity. Tool is then administered to 100 children with nephrotic syndrome. Item analysis was done to finalize the items in the scale and reliability estimated with split half technique (r= 0.93). Results: Nephrotic Syndrome Paediatric Quality of Life (NSPQOL) assessment scale was finalized with 35 item using four-point rating scale. Conclusion: The findings of the study suggest that the tool has potential for use as both a clinical as well as a research instrument.

Background: Obesity is one of the most important modifiable risk factors in the pathogenesis of lifestyle diseases like atherosclerosis, hypertension and type 2 diabetes mellitus. Overweight or obese adolescents are at an increased risk of developing diabetes and hypertension in future. A study was done to determine the relationship between body mass index and fasting blood glucose among students of a tertiary care teaching hospital. Materials and methods: A cross sectional analytical study was carried out among all medical students in a tertiary care teaching hospital in Kerala who consented to participate after obtaining approval from Institutional Research and Ethics Committee. The study tools used were standardized weighing machine, stadiometer, Accu-check glucometer and strips, disposable needles and pre-designed questionnaire. Results: Among the 254 study participants, 67% were females. The prevalence of impaired fasting glucose is 18.11% in the study population. No significant correlation was found between fasting blood glucose and body mass index. There was an increase in median FBS as the BMI increases, though not statistically significant (p=0.08). In the linear regression model, the statistic R2 explains that 7.9% of the variability in fasting blood glucose is explained by body mass index. Conclusion: The prevalence of prediabetes among the study participants was very high and it was higher among those who were overweight. The need of the hour is to identify the high-risk group in the community right from the young age and initiate trials or intervention studies to prevent or delay the onset of diabetes.

Breast cancer is the top cancer in women worldwide and its incidence is increasing, particularly in developing countries. In the United Arab Emirates (UAE), many cases are first diagnosed in later stages and at younger age compared to those seen in developed countries. Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. Performance of breast self examination is one of the important steps for identifying breast disease at an early stage, by the woman herself. No information has hitherto been available about the frequency of this practice among female university students in UAE or about their breast cancer risk perception and therefore the present study was conducted in Ajman. It was found that 22.7% of the participants practiced BSE but only 3% of them practiced BSE monthly. Marital status but not age as significantly associated with age likelihood. The most frequent reported barriers for BSE were lack of knowledge, considering oneself not at risk and the absence of doctor advice. These factors need to be taken into account in intervention efforts.

Note: a new paragraph 'What this study adds:' was added to page 250 on 27 March 2014. Background Social networking sites are web-based services through which individuals can create a public or semi-public profile within a bounded system, connect with a list of other linked users, and view and interact with a list of their connections and with those made by others within the system. To estimate the proportion of university students using social networking sites (SNS) and to determine the association between SNS use and age, gender, nationality, course and year of study, living context, family size, number of close friends, close relationships, stress related to studies and interpersonal relationships. Materials and Methods A cross sectional study was carried out among 300 students from two universities in Ajman, UAE. A self-administered, content-validated and pilot-tested questionnaire was used. The participants answered questions related to their use of social networking sites and details of socio-demographic variables. The data collected were entered into Microsoft Excel and transferred to PASW 18.0 version. Data were analyzed as frequencies, percentages, means and SDs, and Chi-square test used for associations. The odd ratio was calculated for the significant variables to find the degree of association. The SNS usage was categorized as average, moderate or high based on mean and SD on the SNS test score. Results The study population was comprised of 41.6% males and 58.3% females. 89% used social networking sites (SNS) and 11% were non-users. Of the 267 users of SNS, 58.8% were average users, 37.8% moderate users and 3.4% high users. Students in the first and second years of study, small family size, age below 20 years, male gender, being in a non-medical study program, friends in close relationship were found to be associated with higher SNS use. Conclusion Social networking sites were found to be popular among a large number of university students in the UAE, this being more so among males and non-medical students of first two years of study. DOI: http://doi.dx.org/10.3126/nje.v3i2.8512

Objectives: To study various methods of induction of labor and their effect on mode of delivery and fetal outcome. Methods: 104 pregnant women induced in Gulf Medical College hospital from August to November 2009 were included. Mothers were observed from the start of their induction and followed up till they were discharged. The methods of induction compared were the use of prostaglandin, oxytocin, prostaglandin and oxytocin combined and artificial rupture of membranes. Results: Out of 104 pregnant women, 86 (89%) had normal vaginal delivery. Of these, 36 (41.9%) were induced with combination of prostaglandin and oxytocin, 32 (37.2%) with prostaglandin, 14 (16.2%) with oxytocin, and 4 (4.6%) with artificial rupture of membranes. 13 (12.5%) mothers delivered through caesarean section of these, 7 (53.8%) mothers were induced with prostaglandin, 3 (23%) with prostaglandin and oxytocin, 2 (15.3%) with oxytocin alone, and 1 (7.7%) with artificial rupture of membranes. Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method. Duration of labor between primigravidas and multigravidas were significantly different with primigravidas having longer duration of labor with mean time of 12.47 hours while multigravidas had 9.16 hours. Conclusion: Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method in this study with very good progressing to normal vaginal delivery. Further research is needed on a larger scale to compare other methods of labor induction on parturient to be able to recommend the most effective method of labor induction. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13785 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 81-85

Introduction: It is widely acknowledged that congenital anomalies heavily contribute to infant morbidity and mortality worldwide, with an estimated 9 million infants (7% of all births) born annually having a serious congenital anomaly that result in death or lifelong disability. The objective of our study was to estimate the frequency of congenital anomalies at the Gulf Medical College Hospital and Research Center, Ajman and to estimate the proportion of births with congenital anomalies per 1,000 live births. Materials and Methods: It was a Hospital-Record based descriptive study of the 1,222 consecutive live births from December 2007 to June 2008. Results: There were 84 cases of congenital anomalies among the 1,222 live births; the rate of anomalous births was 68.7 per 1,000 live births or 6.9%. Anomalies of the genitourinary system (40.5%) were the most common, followed by musculoskeletal (28.6%) and cardiovascular (10.7%). Gastrointestinal, chromosomal and multiple system anomalies accounted for 3.6% each and miscellaneous anomalies were seen in 7.1%. Central Nervous system (2.4%) anomalies were the least. Congenital hydrocele (19.0%) was seen to have the highest frequency amongst all recorded anomalies, followed by Talipes or Clubfoot (14.3%). 9.3% of the male and 4.3% of the female population of live births had a congenital anomaly. Birth Weight ( p =0.005) and Gender ( p =0.001) were found to have significant association with the frequency of birth defects. Maternal Age, gravidity, parity, previous abortions, VDRL and Hepatitis B status, Gestational Diabetes, Pregnancy Induced Hypertension, gestational age, maternal and infant blood group, nationality and consanguinity showed no statistically significant association with congenital anomalies. Conclusion: The proportion of congenital anomalies found in our study is alarmingly high and emphasizes the need for more accessible nationwide screening, counseling and surveillance systems. J. Nepal Paediatr. Soc. 32(2) 2012 105-112 doi: http://dx.doi.org/10.3126/jnps.v32i2.5995

Background Elevated blood pressure has been identified as a silent killer contributing to mortality and morbidity worldwide, hence it is essential to identify the high risk individuals at an early age to prevent the progress of the disease and its co-morbid conditions. Objective The objective of the present cross-sectional study was to assess the pattern of blood pressure distribution among students of medical and allied health professions at Gulf Medical University (GMU) Ajman, United Arab Emirates (UAE). Methods The study was conducted from November 2009 to February 2010. GMU has academic programmes such as Bachelor of Medicine, Physical therapy, Pharm D and Dental Medicine with a multiethnic student population. A pretested structured instrument used for data collection and blood pressure was measured using mercury sphygmomanometer. Descriptive statistics such as means and standard deviation were used to summarize the quantitative variables. The association of age, gender and nationality with systolic and diastolic blood pressure was determined by Pearson's correlation coefficient and a p-value ≤ 0.05 was considered statistically significant. Results The systolic and diastolic blood pressures were evenly distributed across all students irrespective of their age. A significantly higher systolic blood pressure in males was observed when compared to females, but the difference was not significant in diastolic blood pressure. In the present study among medical and allied health science students, the distribution of blood pressure was not associated with age. The mean systolic blood pressure and diastolic blood pressure were seen to be higher among Arabs when compared to Non-Arabs though not statistically significant. Family history of metabolic diseases did not show any association with the mean blood pressure. Conclusion There was a strong association for developing hypertension among male when compared to female gender. Key Words: University students; Age; Gender; Nationality; Systolic blood pressure; Diastolic blood pressure DOI: http://dx.doi.org/10.3126/nje.v1i3.5572 Nepal Journal of Epidemiology 2011;1(3) 86-89

BackgroundResilience is the capacity to recover and to cope successfullywith everyday challenges. Resilience has intrinsic andextrinsic components and an effort has been made to studythe intrinsic component and its association with sociodemographicfactors, among the entry level students of theIntegrated Bachelor of Medicine and Bachelor of Surgery(MBBS) course.MethodThe present study was conducted in Gulf MedicalUniversity, using a self-administered questionnaire,comprising of two parts, distributed to all the students whoconsented to participate. The first part contained questionson socio-demographic details while the second partcontained questions on the intrinsic and extrinsiccomponents of resilience of the students. The datacollected was analysed using Predictive Analytic Software(PASW) 18.0 using frequency, mean, SD and median.ResultsAmong the 58 students who participated 24 (41.4%) weremales and 34 (58.6%) females, of which 70.7% were < 20years and 29.3% > 20years. The mean score for the intrinsiccomponent of resilience was 48.9 (SD, 5 and range 35–60).The median scores showed no significant variation (p

Context: Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. Aims: To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables. Materials and Methods: A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. Results: Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. Conclusions: The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

Method Source of data was the records of one private and one government hospital in Northern Emirates, UAE. 294 patients with type2 DM, who attended the hospitals from September to November, 2009 were included. A checklist was used for collection of data. Relevant data were collected from the records, entered on Microsoft Excel spreadsheet and analyzed using PASW 17.0 statistics. Proportions and Chi-square tests were used for assessing the co-morbidity of HT and DL, and control of DM with respect to socio-demographic variables.

Background Urolithiasis is an increasing problem in the United Arab Emirates (UAE). The mean age at onset of urolithiasis varies according to region. Method Records of urolithiasis cases confirmed by ultrasonography during the period 2007 to 2009 were retrieved from the Department of Medical Records. PASW 17 version was used for data analysis.

Background: India is said to be shifting from an undernourished to over nourished population with advances in health, economy and medical care. But there is paucity of information regarding nutritional status of older adults in the country, who are socially and economically insecure. Hence the present study attempts to assess the nutritional status of people above 60 years of age, and to find the factors associated with it.Methods: A cross sectional study was conducted among 129 people aged above 60 years, residing in Pathanamthitta district, Kerala. Mini Nutritional Assessment tool (MNA) was used to classify the respondents as having ‘normal nutrition’ (score 23.5 and above), ‘at risk of malnutrition’ (17-23.5), ‘malnourished’ (

Background: Control of blood pressure is a global challenge and non-adherence to hypertension medications is a public health concern. Patient, medication and system related factors can contribute to non-adherence. The study was to determine adherence to hypertension medications and to understand the barriers to adherence in an adult group in Pathanamthitta District of Central Kerala.Methods: A cross sectional study was conducted in a community setting in 2016, among 139 adults aged 30 years and above on treatment for hypertension for at least six months. Those with gestational hypertension, those having serious comorbid conditions and those unwilling to participate were excluded. The data sheet included basic demographic information and history related to hypertension. A content validated eight item questionnaire was used to assess reported adherence and scores classified level of adherence as good (8), moderate (6

Objective : The goal of this research was to identify familial and non-familial social factors influencing post-secondary students’ choices of career in medicine. Method : The comparative study was conducted in Ajman, among medical students in the beginning three years, and non-medical students at the same educational level. After obtaining verbal consent, the participants completed a pilot tested, self-administered questionnaire which included socio-demographic variables and social factors related to career choices. Result : Among the 135 medical students, two thirds were females and 87.3% were below 23 years of age. Most fathers were South Asians (53%); 80% had professional training; 48% were business persons and 12% worked in the medical field. Among mothers, 61.4% were professionally trained, and 67.2% was engaged in unskilled, semi-skilled or skilled labor. The non-medical students had mostly Middle Eastern fathers (83.5%), were professionally educated (56.3%) and had careers in business (52.9%); mothers of non-medical students were primarily working in unskilled, skilled or semi-skilled occupations (61.4%) and 38% had attained a professional level of education. The majority of medical students perceived their parents to have had strong influence on their career choice of medicine. Among non-familial social factors, ‘friends’ had a significantly weak influence on their career choice. While more medical students chose their career along with parents, most of the non-medical group made the choice on their own. Conclusion : Parents had significant influence on post-secondary career choice in medicine and friends had a weak influence. Career guidance programs should consider including parents at the process of career selection at the secondary level.

Background: In the United Arab Emirates (UAE) tobacco use is rampant. A less reported, yet widely used form of smoking native to UAE is midwakh or dhokha. The aim of the study is to assess the acute effects of smoking dokha (Arabian pipe) on the cardiovascular and respiratory systems among male university students in the UAE. Method: A quasi-experimental study was conducted among 97 male volunteers aged more than 17 years. Blood pressure, heart rate and respiratory rate of each participant, were measured before and immediately after smoking. A self administered questionnaire was used to collect personal details and data about smoking pattern. Results: Mean increases in systolic blood pressures (12 ± 1 mmHg), heart rates (20 ± 2 bpm) and respiratory rates (4 ± 1 breaths/min) were observed (p < 0.001). A mean decrease in diastolic blood pressures (1 ± 1 mmHg) was observed (p = 0.483). Conclusion: Smoking dokha has a significant acute effect on systolic blood pressure, heart rate and respiratory rate. Anti smoking campaigns must address the ill effects of this form of smoking. Results from the study warrant further research into this method of smoking which is becoming more popular.

Introduction: In order to control the tobacco scourge, an array of measures is required. Among them is focusing on adolescent relationships as it has been shown that being in a close relationship with a smoker or a non smoker will in the long run be a major factor in deciding whether the individual adopts smoking for initial non- smokers or ceases the habit for initial smokers. Objectives: To assess the attitude of youth towards other smokers and towards marrying a smoker. Materials and Methods: A cross-sectional study was carried out among 415 students from five universities in the United Arab Emirates (UAE). Self-administered structured questionnaires were used for data collection. The Chi square test was used to detect significant differences between frequencies. Results: Of the 415 participants who provided their gender information, 99 (24%) were males and 314 (76%) were females. Of all the participants, 83.5% were not willing to marry smokers, while 16.5% were willing. Of those whose parents smoked (106) 68% did not like it when their parents smoked, 13.6% had no opinion, 17.5% did not mind, while the other 1% had other thoughts. Of those whose close friends smoked, 43.4% did not like it, 16.2% did not have any opinion, 36.9% did not mind while 3.5% had other thoughts. Conclusion: Most participants, both males and females are not willing to marry smokers and prefer to have non-smokers as spouses. Also, smokers are seen as less attractive by both genders in contrast to what appears as popular beliefs amongst youngsters and what is depicted in tobacco advertisements. Tobacco control activities can be undertaken in the community and colleges by incorporating students as facilitators.

Objectives: This study intended to determine the degree of influence of the media on the body image of students in the United Arab Emirates. Materials and methods: This cross-sectional survey collected data from 372 school and college students residing in UAE (129 males, 243 females) using a self-administered questionnaire. The data collected included sociodemographic characteristics, height, weight, social factors, and influence of different media on perceived body image. Data was entered on Microsoft Excel and analyzed on PASW 18.0 version using chi-square test for association and data presented as descriptive statistics. Results: Twenty eight percent of the study group reported media to be the most influential factor on perception of appearance, of which internet was found to be the most influential medium (47.3% males and 42% females) on body image, followed by television (31% males and 37% females). Media were not as important as “attitude of family” (37.4%), “attitude of the opposite sex” (36.9%) or “attitude of friends/peers” (34.7%) which ranked highest among the most influencing factors. Media were considered moderately influencing (37.4%), with the other factors having almost equal importance. Media had effect only on the emotional and cognitive aspects. It was found that no single factor among the tested influential factors had a great impact on the body image of the youth of UAE, though there were several moderately influencing factors of almost equal importance. The overweight participants considered media to have ‘strong influence’ (p

BackgroundMedical students’ knowledge and understanding of theelderly will affect the quality of care to the rising populationof older adults which points to a need to identify geriatrichealth training methods appropriate for the region andcurriculum. Therefore the study assessed the effect of a cocurricularintroductory workshop on knowledge regardinggeriatric health and attitude towards the elderly amongfourth year medical students in a medical universityMethodA quasi-experimental before-after study, with control wasconducted at Gulf Medical College among 60 medicalstudents from discipline-based curriculum in year IV duringMay–June 2010 of whom 16 had opted (attendees) toundergo the introductory course, a five day workshop of 10hours duration. Pre- and post-testing used self-administeredquestionnaires for demographic variables: age, gender,nationality, close contact with older people; a quiz on oldpeople’s health, and Kogan’s Old People Scale (KOPS) forattitude. The difference in scores on quiz and KOPS werecompared for the attendees and 26 non-attendees whoparticipated in both pre and post testing.ResultsThe attendees group had 38% male and 62% femaleparticipants and the non-attendees group had 21% and 79%respectively. The groups were not significantly different inage, sex, nationality and close contact with the elderly. Thescores on the quiz and KOPS showed no statisticallysignificant difference between the two groups before orafter the workshop. Almost all the participants evaluatedthe workshop very positively especially the interaction withhealthy elderly and inmates of old people’s home.ConclusionA 10-hour introductory co-curricular workshop made nosignificant change in the knowledge on geriatric health orattitude of fourth year medical students though theyreported it as a very enriching experience. A reflectivereport may have been a better assessment tool and theimpact on their clinical practice cannot be predicted.

Globally, tobacco is considered to be one among the leading causes of death. Dokha is a mixture of Iranian tobacco with aromatic leaf and bark herbs, smoked in a small pipe termed a Midwakh thought to have originated in the Arabian Peninsula. The present study aimed at evaluating the prevalence and pattern of dokha use among Medical University students. Prior to participation in the study, the students were provided with information on the purpose of the study and also assured that confidentiality would be maintained. A self-administered questionnaire was then utilized for collection of data which were processed using Excel spread sheet and analysed using PASW 17. A total of 104 students between 17 and 27 years of age participated, 75% of the respondents being females. The prevalence of dokha smoking was higher among male participants than females. Among dokha smokers, the majority (18.6%) were from the College of Allied Health Sciences. 11.5% reported as being lifetime smokers of dokha and 25% had smoked dokha daily over the past month. We conclude that dokha use among our target population is common and hence favor developmentn of an anti-smoking program for university students.

Background: An extensive primary health care system exists in India, yet it is inadequate in terms of coverage of the population, especially in rural areas, and gross underutilization. Assessment of the utilization of public health services is important for the health of a nation. Aims & Objective: To assess the utilization of public health services in a rural area and an urban slum in Maharashtra, India Material and Methods: A community based cross sectional study among 800 families, 400 each from a rural area and an urban slum in Karad, Maharashtra. Data was collected from the head of the families using a pretested questionnaire. Chi square test was applied to find any significant difference between the two areas in health seeking behaviour. Results: The utilization of public health services was very low in both the study areas and the main reason for non-utilization in rural area was because the centre took money for the services when it was supposed to be free and in the case of urban slum the centre was far away. Conclusion: The utilization of public health services is poor in both areas. It is important to revitalize the health system, encourage the utilization and provide better facilities for the health staff for effective delivery of service.

Background: Complementary and alternative medicine (CAM) covers a wide range of approaches, including herbal medicine, manual healing techniques, traditional therapies and mind-body interventions. CAM is widely used throughout the world to treat a variety of illnesses and to maintain health. Aim: Complementary and alternative medicine (CAM) is popular across the world, and is widely practiced. Utilization pattern and reasons for use and non-use among patients attending a tertiary care center are assessed in this study. Subjects and Methods: One hundred and thirty-five patients of different nationalities, above the age of 18 years, Gulf Medical College Hospital and Research Centre, Ajman, UAE, were interviewed using an open-ended structured questionnaire. In addition to socio-demographic characteristics, the acceptability, utilization pattern and reasons for use and non-use were elicited from the participants after obtaining consent from them. PASW 18 version was used to perform Chi-square test and descriptive statistics. Results: Among the 135 participants were 20-81 years old, those from the Far East used most 85.7% (6/7), then Pakistan 38.5% (15/39) and India 23% (16/70). The most common system used was homeopathy. Physicians advised 28.2% (11/39) of users, whereas others used non-medical information. Around 71.8% (28/39) reported good outcome for themselves and family; however, only 10% (4/39) recommended it to others. Most of the users, 75% (101/135), were not sure whether CAM was based on scientific evidence, while 18% (24/135) felt it was. Good previous experience and less treatment complications were the most common reasons for using CAM and non-use due to lack of knowledge or need. Conclusion: About one-third of the seekers of modern medicine care also use CAM, and mostly without physician advice; hence, the importance of discussing the same while taking the clinical history. In view of the belief that CAM has fewer side-effects, there is even more need for physician-initiated discussion.

Background Youth is a vulnerable group for developing almost all life-style related diseases. The present cross-sectional study was conducted to assess the determinants of blood pressure among entry year students in a medical university in Ajman, United Arab Emirates. Materials and Methods One hundred and ten students from Gulf Medical University, Ajman, UAE participated in the study. A pretested structured questionnaire was used for data collection. Predictive Analytic Software 17 was used for data analysis. Chi-square test, Univariate and multivariate logistic regression were used. Results Variables such as tobacco use, duration of sleep, Body Mass Index and gender were considered to assess the association with blood pressure. The mean age of the students was 19 years with a SD of 1.9 years. The mean systolic and diastolic blood pressure was 113.5 (SD 12.0) and 73.7 (SD 11.2) respectively with mean BMI of 24.9 (SD 5.7). A statistically significant association was observed between gender and blood pressure (p