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Background and Objectives: The current picture of the Saudis' use of complementary and alternative medicine (CAM) has not yet been developed. The aim of this study was to assess the feasibility of using the international questionnaire to measure use of complementary and alternative medicine (I-CAM-Q) in Saudi Arabia to evaluate the use of and out-of-pocket spending on CAM., Design and Settings: It was a cross-sectional study, conducted in 2011, in primary health care centers in Qassim., Methods: In a multistage sampling technique, 12 primary health care centers were selected randomly in the Al-Qassim province in Saudi Arabia. From each center, 100 attendants were interviewed for a total of 1160 completed questionnaires., Results: A total of 74% of subjects had visited CAM providers in 12 months before the survey. This percentage decreased to 47.6% when spiritual healers were excluded. The specific CAM providers who were visited were spiritual healers (26.7%), herbalists (23.2%), providers of honeybee products (14.9%), and hijama (wet cupping; 13%). Chronic illnesses were the main reason for the visits. A total of 50% of subjects were satisfied with their visit. Physicians were the providers of CAM for 11.3% of the participants. More than 75% of the subjects used herbs in the previous 12 months for medical and health reasons, while only 25% used vitamins or minerals. Self-help was used in 26% of the participants. Relaxation (10.3%) was the most common self-CAM practice followed by meditation (6.7%). The subjects spent 350000 (US$) on CAM visits and 300000 (US$) purchasing CAM products., Conclusions: I-CAM-Q can be used in different populations and cultures in the East including Saudi Arabia after customization to overcome its limitations, as the questionnaire was developed in Western societies.

Objective: To study medico-legal litigations and related medical errors in Central (Al-Qassim), and Northern (Hael) districts in the Kingdom of Saudi Arabia (KSA), and to identify types and causes of errors to reduce medical errors and patient harm., Methods: This retrospective prevalence study was carried out between May 2010 and December 2011 to analyze medico-legal litigations in Al-Qassim and Hael districts that were investigated by the Al-Qassim Medico-Legal Committee, Al-Qassim, KSA. Final verdicts issued between 1992 and 2009 included 293 cases., Results: The patient`s mean age was 29.5 years. Fifty-seven percent of the patients were females, and 92% were Saudis. The Obstetric and Gynecology department was involved in 29.7% of litigations followed by General Surgery, and Pediatrics (11.3% each). Of the 635 defendants, 90% were physicians, and 7.6% were nurses. Investigations showed no error in 47.1% of cases, error but no harm in 11.9%, and error resulted in harm in 39.6%. Errors were negligence (45.8%), wrong diagnosis (14.2%), surgical error (10.3%), and administrative error (5.2%). The average total duration of litigations was 13.9 months. Type of harm was the most significant predictor to determine a guilty decision (p<0.001)., Conclusion: Obstetric practice in Al-Qassim and Hael districts and provider negligence contribute to a large portion of medico-legal litigations, and therefore this has to be further studied to recognize the specific causes and possible interventions. A systematic review of the medico-legal committee is needed to shorten the long duration of litigation.

In 2001, the measles immunization schedule in Saudi Arabia was changed to 2 measles, mumps and rubella vaccine doses at 12 months and at 6 years. In this follow-up study we evaluated the seroresponse to the second measles dose before school entry. We recruited 138 children randomly from primary health care centres in Qassim; 124 children completed the study. Blood samples were collected before and 1 month after giving the second measles dose, before the age of 6 years. There was a statistically significant increase in the geometric mean titre of measles antibody, from 2205 m IU/mL before vaccination to 4723 mlU/mL after (P = 0.0001). The proportion of children with positive ELISA results increased fro++ 94.2% before vaccination to 99.2% after (P = 0.02), while the proportion with protective level (> or = 200 mlU/mL) increased from 97.1% before vaccination to 99.19% after (P = 0.21). The 2-dose measles immunization schedule can produce optimum protection at school entry if high vaccination coverage is guaranteed.

Objective: To evaluate the sero-response to measles component of the first measles, mumps and rubella MMR dose given at 12 months by measuring measles antibody before and one month after the vaccination., Methods: A follow-up study where, 57 children at the age of 12 months were recruited randomly from the Primary Health Care Centers in Qassim, Saudi Arabia using a multistage sampling techniques. Fieldwork was conducted from October until December 2006. Blood samples were collected to measure measles IgG antibody before, and one month after giving MMR using enzyme linked immunosorbent assay. Data were compared before and after vaccination using geometric mean titer GMT and seroconversion., Results: In the 57 infants, positivity rate increased significantly from 3.5% (2/57) pre-vaccination to 100% one month after p=0.0001, and with a sero-conversion of 96.5% (55/57). Also, GMT increased significantly from 0.014-2.172 IU/ML, after vaccination p=0.0001., Conclusion: Sero conversion and GMT are significantly high after the first MMR given at 12 months and this is supported by the surveillance data in Qassim.

Since the burden of disease has shifted towards non-communicable diseases and public health management, there is a greater need to direct resources to address risk factors of the diseases rather than the diseases themselves. The downstream agenda focused on treatment services and is still an important problem at the level of national health management. Much has been accomplished in preventive programs for infectious diseases in Saudi Arabia but a great deal more is needed to combat non-communicable diseases. While a national non-communicable diseases program is being established in the Kingdom, more advanced pilot projects of NCD can be started in the regions. A model for cardiovascular diseases in Qassim will be presented.

Objective: A follow-up study, to compare the short-term outcome of preterms, in two hospitals in Al Qassim region, Saudi Arabia., Methods: Preterms admitted in two hospitals, 47 in hospital A and 36 in hospital B, were followed from admission until one month after discharge. Preterms were compared on gestational age, birth weight, birth head circumference and length of stay. Outcome measures were weight gain per day, feeding patterns on discharge and feeding patterns one month after discharge compared with the feeding of normal infants (200 infants) at the age of 6 weeks., Results: No difference was found between the two hospitals on admission in gestational age, mean birth weight, birth head circumference and length of stay. Mean weight gain per day was significantly higher in hospital A, 9.56 (± 19.7) gm, compared to 1.22 (± 29.47) gm in hospital B. (P=0.049). But the proportion of exclusive breast fed infants, one month after discharge was higher in hospital B, 37.5% compared to 13.2% in hospital A. (p=0.0224)., Conclusion: Our study showed that there is a clear hospital level difference in the same region, in the short-term outcome. This emphasizes that outcome should be continuously followed and that differences should be evaluated in perinatal audit procedure.

Objective: To evaluate CME activities in Al-Qassim region in the Kingdom of Saudi Arabia, Methods: A study using a pre-structured questionnaire was conducted in Al-Qassim, targeting physicians working in the hospitals. The survey was conducted in two phases. The first phase was conducted at the inception of the department of professional education and the second one year later. Questionnaires were given to a sample of physicians working in the hospitals., Results: Mean CME hours in the region increased from 5.5(±5.9) to 14.2(±19.7), p=0.0001. 50% said that the CME should be presented differently. There was a need for regular courses (61%), departmental and bedside activities (52%) and visiting speakers (45%). Only 47% of the physicians were using the Internet., Conclusion: There is a need to shift from credit counting to a process that can yield professional development through practical courses and departmental activities. The use of the Internet in CME activities should be encouraged.

Background: Accurate information about acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) is important for their prevention., Objectives: This study is intended to assess knowledge on AIDS in students of secondary schools in Buraidah City and to measure the effect of a health education program on their knowledge about AIDS in general, modes of HIV transmission and the degree of their misperception about the transmission of the disease through casual contact., Methodology: A well-designed health education program using personal communication and visual media techniques was conducted for 483 secondary school students in Buraidah secondary schools during the year 1997. Pre- and post-tests were done to examine their knowledge about AIDS., Results and Recommendations: The results of this study pointed out that a health education program on AIDS for students of secondary schools greatly and significantly improved their scores on general knowledge on AIDS views on its transmission and misperception of AIDS (p < 0.01). Continuous in-ice programs for secondary students are recommended.