Table of Contents

Original Articles

Prevalence of Obesity and its Risk Factors among Preschoolers in the Kingdom of Bahrain

Maryam Hasan Kamal1*, Anfal Jamal Hijris2, Rawan Nayef AlKhashram3, Yara Khalid Algillidary3, Abdulla Khaled Alhammar4, Mohamed Ismaeel Janahi5, Yasser Ahmed Bamasood5, Osama Mohammed Nazzal6, Faisal Osama AlAli7, Rashed Ali Aldoseri8

Pages: 1-8
  • Abstract
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  • Background: The increasing rates of obesity have raised worldwide concern due to its impact on the individual and society. The prevalence and modifiable risk factors of obesity among preschoolers are crucial to identify for early intervention.

    Materials and Methods: A total of 500 Bahrainis aged 3-6 years were selected via a multistage convenient sampling technique. This cross-sectional study was conducted in 10 health centers from five health regions in Bahrain during September 2018. A data sheet and questionnaire were filled out by parents. The World Health Organization (WHO) body mass index (BMI) growth charts were used to assess the weight status in children by interpreting z-score. The data was entered and analyzed using SPSS v23, MINITAB, and WHO Anthroplus.

    Results: The prevalence of obesity among Bahrani preschoolers in 2018 was 6%. Physical activity, maternal education, and sleeping duration (in males) were associated with obesity. At the same time, the type of delivery, feeding during the first six months, screen-based media use, paternal education, sleeping duration (in females), and dietary habits were not associated with an increased risk of obesity.

    Conclusion: The prevalence of obesity in preschoolers increased from 5.2% in 2013 to 6% in 2018. A positive correlation was found between decreased duration of physical activity and obesity in preschoolers. Likewise, preschoolers with mothers of no formal education or with a post-graduate degree had a higher risk of being obese. In addition, sleeping for more prolonged durations showed an increased risk of obesity in male preschoolers. All other studied factors lacked a significant relationship with obesity.

    Keywords: BMI, Obesity, z-score, Bahrain

Knowledge Level of Alzheimer’s Disease among Adults Attending Primary Healthcare Centers in the Kingdom of Bahrain

Fajer Alammadi1*, Zahra Almosawi1, Nusaiba Alabbasi1, Maryam Janahi1, Maryam Abdulla1, Behnaz Tadayyon2

Pages: 9-26
  • Abstract
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  • Background: With the increasing number of older population in Bahrain, multiple neurodegenerative diseases are arising, including Alzheimer’s disease (AD). Complications related to AD progression and morbidities have introduced new challenges to the patient and the caregiver. Objective: The aim of this study was to assess the knowledge of AD among adults.

    Methods: A cross-sectional study was conducted in primary care centers using two tools randomly distributed to adults attending the centers. The two tools used were a questionnaire measuring AD awareness and a validated Alzheimer’s disease Knowledge Scale (ADKS), which measures knowledge across seven categories.

    Results: A total of 620 respondents were included in the study. Most were Bahraini (88.9%) middleaged adults (25-39 years). Only 13.2 % of the participants had a family history of a relative with AD. Of the 620 participants, 431 scored more than 50%. The mean of the overall knowledge score was 57.6%, with a standard deviation of 11.8. The results showed that females were significantly more knowledgeable about AD, with a p-value of 0.04.

    Conclusion: Our study results identified gaps in knowledge about Alzheimer's disease. Advocacy for health promotion is necessary to raise awareness about the disease.

    Keywords: Alzheimer’s disease, Dementia, Knowledge, Primary Healthcare, Bahrain

The Impact of Covid-19 Pandemic on the Education and Wellbeing of the Residents in the Family Practice Residency Program in the Ministry of Health in Bahrain

Maryam Altamimi*1, Zainab Alghaiss1, Maryam Alawi1, Noora Alammadi1, Zainab Algallaf1, Reem Almurshed1, Naeema Budhaish2, Mohemmed Mandeel3

Pages: 27-36
  • Abstract
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  • Background: The global spread of SARS-CoV-2 profoundly affected physicians, especially the trainees in residency programs, in terms of psychological, social well-being, and educational aspects. However, the extent of its impact and how it compromises their quality of life and care has not been established well.

    Objectives: The aim of our study is to assess the impact of SARS-CoV-2 on psychological, social wellbeing and education among the trainees in residency training programs in the Ministry of Health in the Kingdom of Bahrain.

    Methods: A cross-sectional study was conducted on 89 trainee residents in February 2022 using the perceived stress questionnaire distributed over social media platforms to be answered online. The questionnaire was composed of 4 parts: demographics, the impact of the COVID-19 virus on psychological well-being, training, and education. A p-value cut-off point of <0.05 at a 95% Confidence Interval (CI) was used to determine statistical significance.

    Result: Of the 89 questionnaires distributed, 85 trainees responded (95.5%). Residents who covered COVID-19 centers for more than four months had a higher impact on their training than those who covered less than two months. Female trainees were more affected than males. However, there was no significant difference among genders regarding the level of stress and psychological well-being.

    Conclusion: The adoption of new strategies in the training department for the trainees is recommended to decrease the adverse psychological effects and to prevent any compromise in the training in future pandemics.

    Keywords: COVID-19, SARS-CoV-2, Pandemic, Trainees, Family Practice, Psychological wellbeing, Residency

Predictors of Success in Ponseti Casting, A Single Center Cross-sectional Study

Mahmood A. Alam1, Fatema Nasser Abdulaziz2, Ahmed F. Shirazi3, Sadaf Mohammed Bahseer4

Pages: 37-44
  • Abstract
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  • Background: Congenital talipes equinovarus (CTEV), also known as club foot deformity, is a common deformity with an estimated incidence of around 1 in 1000 live births. The deformity consists of four components: Ankle equinus, hindfoot varus, forefoot adductus, and midfoot cavus. Various approaches exist to correct CTEV, with most authorities advocating a conservative closed reduction approach with serial casting.

    Objective: Pirani scoring has been shown to correlate with the severity of CTEV and has been verified to track response to casting treatment. This study aimed to identify the relationship between initial presenting Pirani scores and other factors on the final Pirani score and the need for surgical intervention for patients managed with Ponseti casting in a single-center observational study design.

    Methods: A total of 24 patients were followed across the duration of the study and serially assessed with the Pirani scoring system. The scores were charted and studied to determine patterns that predict the success of Ponseti casting in those children.

    Results: The data showed that tenotomy is most likely corrective of the deformity in those with higher PS. While the age of diagnosis and age of casting were not significantly impactful, careful follow-up and discussion of goals with the family members are essential for expected outcomes, especially for those hesitant to undergo surgical interventions and those with higher Pirani Scores.

    Keywords: Clubfoot; Humans; Child; Congenital equinovarus; Foot Deformities, Acquired; Foot Deformities

The Prevalence of Substance Use Disorder Among University Students in Amman, Jordan

Narges Alsammak1*, Mohamed Alabbasi1, Abdulaziz Abdulhadi3, Fatemah Mohammad1, Mohammad Alajmi1, Abdilya Alabdaly1, Yaseen Ammar1, Rand D Abbas1, Malak Aldousari1, Aisha AlEssa1, Homoud Alballam1, Mohammed Hayati1, Zaid Alkayed2, and Radwan banimustafa2

Pages: 45-66
  • Abstract
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  • Background and objectives: Substance misuse is a growing global health problem with particular relevance to university students. Despite this being a significant health problem among an important age group, there is a need for more data on university students in the Middle East. In this study, we aim to assess the prevalence of substance misuse among university students in 3 universities in Jordan to provide up-to-date data.

    Methodology: This is a descriptive cross-sectional study. Participants were recruited from three governmental universities in Jordan. An online multiple-choice questionnaire was distributed via QR code, and SPSS version 25.0 was used to analyze the gathered data.

    Results: A total of 1184 participants were recruited, consisting of 729 (61.6%) female and 455 (38.4%) male participants. From the total sample, the lifetime prevalence of illegal substance misuse was 11.8% (n=140), from which the most misused substance reported was sleeping drugs, including benzodiazepine 45% (n=63). Of our total sample, 38.8% (n=453) for smoking tobacco and 6.2% (n=73) for alcohol consumption.

    Conclusion: Substance misuse among university students was high compared to the general population’s prevalence, and it is believed to be underestimated. The results of this study that capture substance misuse prevalence and the identification of associated factors provide up-to-date data that is potentially informative for further analyses and useful to establish awareness campaigns that aim to enhance health status and the ultimate quality of life among young adults.

    Keywords: Alcohol, Illicit substances, drugs, University student, Smoking, Substance misuse.

Case Reports

Malignant Hyperthermia in the Dental Setting: A Case Report

Ahmed Khalfan1*, Khadija Hamed2, Omar Mustafa3

Pages: 67-70
  • Abstract
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  • Understanding rare diseases, such as Malignant hyperthermia (MH), will help provide optimal care to these patients, especially in dental settings. As MH is a sporadic, inherited disorder, dental clinicians must have sufficient knowledge and information about such a rare disease to manage a patient with such a condition. This article will describe a case with MH, highlighting the patient’s or parents’ concerns about using local anesthetic agents in dental treatment.

    Keywords: Malignant hyperthermia, CACNA1S, RYR1, Whole exome sequencing, inhalation agents.