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Introduction: Successful recruitment of participants into clinical research has always been challenging and is affected by many factors. This systematic review aimed to explore the perceptions and attitudes as well as identify the factors affecting the participation in clinical research among the Eastern Mediterranean Regional Office countries’ population. Methods: A systematic search of the literature was conducted to explore attitudes or perceptions of the general public or patients towards participation in clinical research. PubMed, Pro-Quest Central, World Health Organizations Index Medicus for the Eastern Mediterranean Region, and Google Scholar were searched. Studies were considered eligible for inclusion if they presented primary data and were conducted in one of the Eastern Mediterranean Regional Office countries. A data extraction sheet was used to record the following: year, country, aim, population, sample size, study design, data collection, and setting. The identified factors from the included studies were categorized into motivators and barriers. Results: In total, 23 original research articles were identified that addressed perceptions or attitudes towards clinical research participation. Six main motivators and barriers of research participation among patients, the general public, and patient family members were identified. The most common cited motivators included personal benefits to the individual, altruism and the desire to help others, the research process, the influence of the physician, family encouragement, and religion. Concerns regarding safety, confidentiality, and other factors in addition to the research process, lack of trust in healthcare providers or healthcare system, lack of interest in research and no perceived personal benefit, religious concerns, and family/cultural concerns were the most cited barriers to participation. Conclusion: The identified motivators and barriers are essential to tackle during clinical research planning among the population of Eastern Mediterranean Regional Office countries. Further research is needed to assess the attitudes and perceptions of individuals approached to participate in trials.

INTRODUCTION Smoking is one of the most serious health issues. One form of tobacco use, shisha, is prevalent in the Eastern Mediterranean Region. There is a misconception among smokers that waterpipe use poses no harm to human health. In Qatar, the Global Adult Tobacco Survey in 2013 has shown that 3.4% of adults in the country were current waterpipe users. Nevertheless, there remains a scarcity of data on the knowledge and practice of shisha smokers in Qatar. METHODS This was a cross-sectional study across three primary healthcare (PHC) centers in Qatar between September and December 2020. A convenient sampling technique was employed to enroll participants. Upon consent, an interview was conducted to collect data from adult smokers (aged ≥18 years). Descriptive and analytic statistics were used when appropriate. RESULTS A total of 281 individuals participated in this study. Nearly half (48.8%) were current shisha users and almost three-quarters (72.9%) had inadequate knowledge in this regard. In addition, only one-fifth (19.5%) of participants attended smoking cessation clinics at the primary healthcare centers and a quarter (25%) of the respondents managed to quit smoking before relapsing. A significant association was found between the shisha knowledge of participants and their nationality (Qatari), employment status (unemployed), smoking status (current smoker), and duration of smoking. CONCLUSIONS The study results convey a high prevalence of shisha use (47.8%), inadequate shisha knowledge (72.9%), and lack of awareness about available smoking cessation services (46.6%) among the participants. Further research is recommended to generate evidence on the determinants of shisha use and knowledge among the attendees of primary healthcare centers in Qatar.

Multiple choice question (MCQ)/item is one of the common objective type of questions, which is being used extensively in most of the examinations. If MCQ is constructed in appropriate way, it can be an effective and efficient way to assess learning outcomes. Multiple guidelines are available from various resources regarding construction of MCQ/item. The objective of this paper was to provide simplified and easy to remember guidelines of MCQ writing to medical teachers; so that they can easily practice into their regular teaching activities. The following MCQ writing guidelines are given in mnemonic form so that teachers/readers can easily memorize without any difficulty.

An increase of lifestyle diseases (LSDs) has been driven by predominantly four important risk factors viz. unhealthy diet, hazardous alcohol use, tobacco use and physical inactivity. The present paper is envisioned to emphasize personal viewpoints and elucidations about vital role of behavioral risk factors in the management of lifestyle diseases particularly regarding Obesity, Type 2 Diabetes (T2DM) and Hypertension as well as an associated risk of pharmacological measures in treating such illnesses. Type 2 Diabetes is considered as irreversible and incurable chronic disease based on traditional means of management. Though, the current research promotes complete reversal of diabetes with the help of simple lifestyle measures. Health care professionals are encouraged to converse with their patients regarding health benefits of exercise, healthy diet and other lifestyle measures. Patient centered behaviour involving reducing tobacco use, controlling alcohol consumption, improving sleep patterns, balanced diet and mental wellbeing should be targeted by health care professional. Early diagnosis, prompt initiation of healthy lifestyle measures and delayed drug treatment could be an effective strategy not only to combat LSDs but also to develop positive attitudes towards life.