Ahead of Print

Review of Patients Referred to the Emergency Department

Ghada Al Qassim1*, Abubaker Mohammed2, Hytham Ghanem3, Ehab Musbah4, Aysha Khamis Alkaabi5, Salah Al Ghanem6

Pages: 37-42
  • Abstract
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  • Background & Objectives: The main role of emergency care involves providing immediate treatment and attention to patients with life threatening conditions. Critical patients are referred to the emergency department through primary medical services. In this study we reviewed referrals made to the Emergency Department (ED) from primary health care facilities in order to maintain adequate and quality care to patients in need of emergency services.

    Methods: Patient hospital records were reviewed and analyzed over a period of 3 months. We included all patients who were referred to our ED through primary health care services during this period. Data was collected on the date, time, indication for referral, triage level, diagnosis, and outcome.

    Results: In this study with 1094 patients, referrals for patients below 14 years (59.1%) were higher compared to adult referrals (40.9%). The leading causes of referral from all primary health centers to our ED was trauma and injury related (28.8%). This was followed by conditions presenting with abdominal pain (11.3%) and respiratory problems (9.7%). Most of these referrals were safely discharged without the need for further follow up.

    Conclusion: The findings in our study despite the small number and time period of the study provide useful preliminary basis for further research in this area as well as development in the referral system planning and modification.

    Keywords: Emergency Medical Services, Primary Health Care, Quality of Health Care, Referral and Consultation

Spectrum of thyroid nodules in a tertiary care center in the Kingdom of Bahrain

Safa Alshaikh1, Kameela Sayed Majed1, Nisha Chandran2, Sayed Ali AlMahari2

Pages: 32-36
  • Abstract
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  • Background: This study investigates and analyses the thyroid nodules in Bahrain, and correlates the diagnosis of cytopathology with a subsequent excision histopathology.

    Materials & Methods: We conducted a retrospective study for all thyroid cases diagnosed at the Salmaniya Medical Complex during a 7-year period (January 2013 to December 2019).

    Results: A total of 1218 thyroid nodules were diagnosed during the study period. Among them, 1,037 (85%) of the patients were females and 181 were males (15%), with an average age of 48.2 years. Surgical excision was performed on 263 out of 1,037 (25%) of the cases.

    Conclusions: The study revealed that the prevalence of thyroid nodules is higher among females. The most common nodules are benign multinodular goiters. A statistically significant correlation was observed between fine needle aspiration cytology (FNA) and surgical excision of the thyroid nodule.

    Keywords: Thyroid, FNA, thyroid nodules, cytology, excision

End Stage Renal Disease in Children in Bahrain: Etiology and Outcome

Deena Mohamed AL Mastoor*, Fatima Shabib

Pages: 27-31

Survey of Primary Care Physicians’ Knowledge, Practices & Perceptions of Prediabetes in Bahrain

Bahnaz Tadayyon¹*, Mona Qader², Shahla Al-Doseri³, Eshrat Ghuloom4, Adel-AlSayyad5

Pages: 15-26
  • Abstract
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  • Background: Prediabetes is a condition that develops before diabetes and can be treated with intensive Lifestyle Modifications (LSM). This study aimed to assess the knowledge, practices, and perceptions of Primary Care Physicians (PCPs) toward prediabetes in Bahrain.

    Methods: PCPs in the study were surveyed using a cross-sectional questionnaire in all 28 governmentrun Primary Healthcare Centres (PHCs) in Bahrain. We used descriptive statistics to analyse the data, which were then reported as percentages.

    Results: From 378 PCPs, 263 completed the questionnaire. The physician’s knowledge of prediabetes Risk Factors (RFs) and HbA1C laboratory criteria to diagnose prediabetes was inadequate. As an initial step to manage prediabetes, 12.5% of PCPs refer patients to Diabetes Prevention lifestyle change Programs (DPPs). Moreover, 15.6% recommend 7% minimum weight loss, 57.8% recommend 150 minutes per week of physical activity and 67.7% recommend prescribing metformin. Overall, our study revealed that General Practitioners (GPs) had inferior knowledge to Family Physicians (FPs). According to PCPs, diabetes prevention is hindered by both individual and system-level challenges (e.g., Inadequate motivation and resources to lose weight). Furthermore, PCPs consider that improved access to DPPs and coordinated referrals to them could delay diabetes.

    Conclusion: Risk stratification, appropriate diagnosis, and intervention at the prediabetes stage are of critical importance for preventing diabetes. Increasing awareness of the public regarding prediabetes complications and educating healthcare providers, especially GPs, on screening guidelines, diagnostic criteria, and evidence-based management options for prediabetes can bring us one step closer to slowing the diabetes epidemic in Bahrain.

    Keywords: Bahrain, Primary care physician, Knowledge, Practice, Perception, Prediabetes

Knowledge, Attitude and Practice of Public School Teachers Regarding Traditional Bone Setters, Khartoum Locality

Pages: 9-14

Evaluation of Preschool Screening Program in the Kingdom of Bahrain: A Survey in Primary Healthcare Centers

Muna Al Mohri1*, Hala Al Asoomi2, Batool Hasan3

Pages: 1-8
  • Abstract
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  • Background: Preschool screening is one of the services provided by primary healthcare centers, in the Kingdom of Bahrain, for children aged 5 to 6 years. This service includes assessing growth and development parameters, which includes measuring hemoglobin levels, conducting vision examinations, and administering Purified Protein Derivative (PPD) tests. Objectives: To evaluate the prevalence of anemia, reduced visual acuity, and positive PPD tests, in children’s preschool screening.

    Methodology: This survey was conducted in 25 primary healthcare centers, between the period of January to March 2020, with a total sample size of 2,637 children. Electronic preschool screening visit sheets, of children who attended the health centers for screening, were reviewed and evaluated.

    Results: Out of the 2,637 records reviewed; anemia, reduced visual acuity, and positive PPD tests, were found in 19.9%, 4.7%, and 0.45% of children, respectively.

    Conclusion: The overall prevalence of reduced visual acuity and positive PPD tests was low. On the other hand, although the overall prevalence of anemia was also low, at about 20%, this can be reduced further by raising physicians’ adherence to anemia management guidelines, at earlier ages. Moreover, further studies are needed to assess the causes and risks of anemia in this age group.

    Keywords: Bahrain, Preschool, Screening, Primary Healthcare Centers, Prevalence