Purpose:The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia.Materials and Methods:A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant.Results:The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 – 72.02%). The non-compliance of males (69.34%) was higher than females (65.45%, P = .003). The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023) in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57),level of education (Illiteracy) (OR = 5.27, CI = 4.63 – 7.19), urban population (OR =5.22, CI= 3.65 – 8.22), irregularity of the follow-up (OR = 8.41, CI = 4.90 – 11.92), non-adherence to drug prescription (OR = 4.55 , CI = 3.54 – 5.56), non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 – 6.), insulin (OR = 1.29, CI = .71 – 1.87), and insulin with oral Metformin (OR = 1.20, CI = .65 – 1.75).Conclusion:The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need for improvement in the healthcare system, health education, and training of diabetic patients.

Purpose:To evaluate the prevalence of diabetic retinopathy (DR) in the urban and rural areas of Al Hasa region of Saudi Arabia and to determine risk factors related to DR.Materials and Methods:This study was conducted on patient attending primary health care centers between July 2007 and June 2009. A retrospective chart review was conducted on subjects with diabetes mellitus greater than 18 years old. Ophthalmologists examined DR status through dilated pupils by using direct, indirect, and slit lamp bio-microscopy. Frequencies, percentage, and their 95% confidence intervals (CIs) were calculated. Odd’s ratio was used to associate DR with possible risk factors. A P value less than 0.05 was considered statistically significant.Results:The prevalence of DR among 473 diabetic subjects was 30% (95% CI: 25.80–34.20). The odd ratios (ORs) of DR among diabetic residing in an urban area was significantly higher than diabetics residing in rural areas [OR = 1.94 (95% CI of OR 0.82–2.89)]. DR was associated to the duration of diabetes (adjusted OR = 1.70), uncontrolled blood sugar level (adjusted OR = 1.96), hyperlipidemia (adjusted OR = 2.04), and hypercholesterolemia (adjusted OR = 2.80).Conclusions:DR appears to be a public health problem in the Al Hasa district of Saudi Arabia, and a planned approach is required to avoid severe visual impairment in patients with diabetes mellitus. Primary prevention and early detection could be implemented through primary health centers and non-ophthalmologists.

Objective: To measure the distance of villagesfrom the facility (BHU) and to analyze the geographical location, Pattern of Access and health facility utilization. StudyPurpose: To improve the health status of community, by improving the geographical patterns of access and healthfacility utilization in Pakistan and to provide necessary information to policy makers, planners and health care providersfor improvement of health facility utilization in Pakistan. Study Design: A cross sectional study. Setting: At UnionCouncil Gali Jagir, Tehsil Fateh Jang, District Attock. Period: From 15 Nov 1999 to 31 Dec 2000. Material & Method:Measurement of the distance from the villages to the health facility and the facility record was reviewed to assess theutilization pattern by the village population. Information about mode of travel, time for travel and cost of traveling wascollected by the key informers. Results: 22% of villages and 23% of population was situated at a distance of 3km fromthe BHU. 33% of villages and 30% of population were living within 5km. 67% of villages and 70% of population wassituated at a distance of more than 5km from BHU.The overall health facility utilization of BHU Gali Jagir is 8.34%.Discussion: The health facility utilization decreases as the distance increases. Geographical accessibility up to adistance of 3km is a new finding in the study. We have noted that majority of the villages and populations, 67% villagesand 70% population is uncovered and 33% villages’ and 30%population is under served. Conclusion: The study hasidentified the gaps in the geographical access patterns that an accessible distance is 3km instead of 5km (as acceptedby world health organization). Distance of 3km was accessible for seeking care from a public health care facility. Theover all health facility utilization was 8.32 %, which was alarmingly low.