Dr. Fouzia is a Saudi female family physician consultant, worked in general practice for several years including outpatient clinics in chronic diseases and maternal and child health. She worked as in charge doctors for junior general practioners, residents or emergency consultation in general practice . She has multiple administrative activities in different displines like patient health education, breastfeeding promotion, committees supervisor, immunization quality coordinator, medical coordinator. She is training the medical students in family medicine block as assistant professor. Currently, She is associate dean of female medical college at AlImam Mohammed Bin Suad University, Riyadh, Saudi Arabia. Fouzia has few research publications including prescribing in diabetes and breastfeeding practice among Saudi population.
| Breast Feeding - The Saudi Experience
Concurrent Workshop Repeated |
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| Saturday, 16 August 2014 | Start 8:30am | Duration: 55mins | Room 10 |
| Start 9:35am | Duration: 55mins | Room 10 | |
| Breastfeeding world week at August 2014 is a way to continue promotion of lactation. General practioners are expected to be part of supporting maternal and child health. Physician has a strong role in counseling parents and consider safe prescribing during lactation and choosing elective procedure time which will not cause mother separation from the infant. General practioners are also a target for milk formula companies representatives and their awareness of the international code and its violation is so important.
In the past century , the practice of breastfeeding was well established culturally in Saudi Arabia. With modernization in social life as well as the recent medical practice, the view to breastfeeding has changed significantly. So, Ministry Of Health (nutrition administration) takes the role of leadership to promote and protect breastfeeding since 1990. Saudi Arabia has also signed the Convention on the Rights of the Child, which is Part of Islamic law as a major backer to promote breastfeeding. Many interventions were carried out and still continuing. The launch of baby friendly hospital initiative and expansion of the concept to primary care centers were in active process in many regions of the country. In 2013, there are 50 medical centers accredited as baby friendly, majority are ministry of health institutions. Medina Munwara region is achieving high standard this aspect and play a model for the rest of the regions. National strategy for promotion of breastfeeding was established and many multi-displinary committees are working to implement it. The code of marketing breast milk substitutes was established as royal decree since 2004. In the last century, the breastfeeding prevalence at national level done and published in 2006 and 2009. It showed a downward trend in lactation practice. However, unpublished recent data indicates an increase practice in duration of breastfeeding by two months. Breastfeeding education and conferences are ongoing in many regions of the country and effort to incorporate the program within medical colleges is underway. Breastfeeding week is celebrated in yearly basis for both the staff and the pubic in English and Arabic languages over many health institutes. The challenges of the program are seen at multiple levels. Saudi society for breastfeeding promotion was tried to be established by advocates. A project of nurseries for working women in every area is ongoing. The penalties from the milk formula companies are under way for its application. Yet, the cultural changes for young mothers are among the major barriers of breastfeeding. |
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| Prescribing in Diabetes
Concurrent Workshop |
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| Saturday, 16 August 2014 | Start 4:30pm | Duration: 60mins | Room 6 |
| Nowadays chronic disease care represents 40 % of general practice. Type 2 diabetes mellitus is considered the top of chronic disease. It is an epidemic disease in the world including NewZealand and gulf countries. The prevalence of diabetes in Saudi Arabia is increasing and considered to be the highest in the world representing 23-30% to adults above 30 years of age. The prevalence in Newzealand is also increasing with increasing prevalence e of obesity . The estimated prevalence of diabetes was 243,125 newzealanders in December 2013. Prescribing practice is considerable in diabetes care. The cost for prescriptions for diabetes care has been estimated to account for 30-40% of direct cost of diabetes. A substantional increase in the cost of medication for diabetes is observed especially for the new anti-diabetic and cardiovascular medications with rising prevalence and more use of the evidence based guidelines. The American diabetic association – standard care 2014 stresses the importance of controlling the metabolic changes by life style as well as the prescription including the hyperglycemia and lipid disorder. It also reinforces control of cardiovascular changes by prescribing antihypertensive and anti- platelets.
A study was carried out in primary care setting in Riyadh , Saudi Arabia on prescription practice among diabetics , 2012 . More than 57% of participants were on two or more drugs for hyperglycemia. Metformin was the commonest drug prescribed. Metformin and sulphonylurea were the most common combined medications; ACE or ARBS were the most common drugs used for hypertension. Diuretics ( thiazide VS indapamide ) were the most common drug used for combination therapy for hypertension. Statins and aspirin were used among by 41 % and 23.8% of the research population, respectively. The recommendation in this study is to increase utilization of insulin , incretins, statins and as per updated standard diabetic care . |
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