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      Knowledge, attitude, and practice of primary health care physicians in the management of osteoarthritis in Al-Jouf province, Saudi Arabia

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          Abstract

          Background:

          Primary health care (PHC) physicians manage most patients with osteoarthritis (OA). In Saudi Arabia, very little is known about the management of OA by PHC physicians. This study aims to assess knowledge, attitude, and practice of PHC physicians in the management of OA.

          Materials and Methods:

          During October 2011, a cross-sectional survey was conducted on physicians who were practicing at the primary care centers in AlJouf province of Saudi Arabia. The physicians were asked to fill a valid questionnaire comprised of 35 closed ended questions, 6 items about their socio-demographic characters, and a very well modified 29 questions about their knowledge, attitude, and practice in the management of OA. Data was processed and analysed using SPSS (version 16) program, the level of significance was set as Chi-square test was applied for analysis of categorical data.

          Results:

          Response rate (77/90=85.6% yielded 77 questionnaires for analysis. The mean ± SD age of respondents was 38 (12.3) years. Majority of the physicians surveyed, 58 (75.3%) considered OA as a common health problem in Saudi Arabia. Only 28 (36.4%) physicians surveyed will achieve continuity of care for OA, whereas more than half (n=44; 57.1%) will refer OA immediately or later to the specialists. The proportion of continuity of care for OA among physicians with diplomas was more than that found among general practitioner (57.1% vs 34.1%; <.05). Only 30 (39%) of physicians appeared to know the radiographic changes associated with OA. 21 (27.3%) of physicians manage an average of 5-10 patients with OA per week. Almost 3/4 th of the physicians ( n=57; 74%) prescribe NSAIDs, and only ( n=14; 18.2%) prescribe acetaminophen for OA. Less than 1/5 th of the physicians surveyed ( n=12; 15.6%) prescribe herbal medicine for OA. Almost all physicians subscribe to regular training programs about OA.

          Conclusions:

          Appropriate attitude with lack of knowledge was found, and practice of our physicians with regards to this disorder appeared inappropriate. More education focusing on the disorder is recommended.

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          Most cited references20

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          Osteoarthritis.

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            An update on the pathogenesis and epidemiology of osteoarthritis.

            Osteoarthritis is a disease affecting all joint structures, not just hyaline articular cartilage. It develops as a consequence of injurious activities acting on a vulnerable joint. The correlation between structural changes of the disease and joint symptoms is poor. Risk factors include age, obesity, and joint injury. Risk factors for symptoms include bone marrow edema, synovitis, and joint effusion.
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              Chondrocyte apoptosis: a cause or consequence of osteoarthritis?

              Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation and changes in the subchondral bone. Over the last two decades, there has been increasing evidence showing association between cartilage degradation and chondrocyte death, and different types of cell death in cartilage have been reported, including apoptosis and chondroptosis as well as necrosis, but which of these types of cell death predominate in OA is debatable. There are also some methodological difficulties in detecting the specific form of cell death in articular cartilage. Current 'gold standard' for detecting chondrocyte death is electron microscopy which suggests that the morphological changes of chondrocytes in OA cartilage are attributed to apoptosis and/or chondroptosis. However, the current literature appears to suggest that classic apoptosis plays an important role in OA; but whether chondrocyte apoptosis is a cause or a result of cartilage degeneration in OA is hotly contested. Studies of suitable animal models, especially longitudinal studies, are needed to address the cause-and-effect relationship. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.
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                Author and article information

                Journal
                Niger Med J
                Niger Med J
                NMJ
                Nigerian Medical Journal : Journal of the Nigeria Medical Association
                Medknow Publications & Media Pvt Ltd (India )
                0300-1652
                2229-774X
                Oct-Dec 2012
                : 53
                : 4
                : 213-219
                Affiliations
                [1]Department of Family and Community Medicine, College of Medicine, AlJouf University, Saudi Arabia
                Author notes
                Address for correspondence: Dr. Al-Hazmi Ahmad Homoud, Department of Family and Community Medicine, College of Medicine, AlJouf University, P.O. Box 2014, Sakaka, Saudi Arabia. E-mail: dr.ahmad medical@ 123456hotmail.com
                Article
                NMJ-53-213
                10.4103/0300-1652.107556
                3640242
                23661881
                9cfaa649-5fb8-4632-bc0d-26337302007f
                Copyright: © Nigerian Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                Medicine
                attitude,continuity of care,knowledge,nonsteroidal anti-inflammatory drugs,osteoarthritis,practice,primary care

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