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PubMed2004

Serum levels of lipids and lipoproteins in Syrian patients with beta-thalassemia major.

OBJECTIVE: Evaluation serum lipids, lipoprotein (a), apolipoprotein A1, apolipoprotein B and total antioxidant status (TAS) in syrian patients with beta-thalassemia major. METHODS: This study was carried out at Damascus University (Biochemical Laboratories of Medicine and Pharmacy Colleges), Syria between May 2002 and April 2003. This study included 30 patients with beta-thalassemia major, aged between 1.5 and 16-years. All patients had undergone regular blood transfusions and iron chelation therapy (through thalassemia center, Damascus, Syria); also 30 control subjects matched for age were studied. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, apolipoprotein A1 (apo A1), apolipoprotein B (apo B), lipoprotein (a) [Lp(a)] and total antioxidant status (TAS) were determined. Blood samples were withdrawn after at least 12-hours of patients fasting and before the blood transfusion. RESULTS: beta-thalassemia major patients had significantly lower total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and lower density lipoprotein (LDL-C) compared with control (P<0.0001, P<0.0001, P<0.003). While serum triglyceride (TG) and lipoprotein (a) [Lp(a)] levels were higher in b-thalassemia patients than in controls (P<0.0001). The reduction was significant (P<0.0001), in apolipoprotein A1 (apo A1) but not significant (P=0.537) in apo B serum levels, in patients compared to control subjects. Total antioxidant status (TAS) values were lower in beta-thalassemia major patients than in controls. CONCLUSION: The results might suggest that beta- thalassemia may represent an interesting metabolic model: anemia, an activated macrophage system and defective liver function seem interrelated to the final serum lipoprotein pattern. This suggests that antioxidants counteract lipid peroxidation processes and have a protective effect against oxidative damage of red cells of beta-thalassemia patients.

Adolescent↗
PubMed1993

[Cancer mortality in immigrants from the Near East in Australia].

A differential mortality study shows that in Australia, between 1969 and 1983, Near Eastern migrants had a lower cancer mortality than the local-born, and that their cancer profile resembled that of the other mediterranean migrants in Australia. Compared to local-born, Near Eastern migrants were characterized by: (1) a lower mortality from oesophagus and colon cancers, and from melanoma, in both sexes, from prostate cancer in men borne in males, from ovary and bladder cancers in females; (2) a higher mortality from liver and thyroïd cancers in males, and from stomach and gallbladder cancers in females. The analysis by country of birth indicates a higher mortality from lung and bladder cancers in men born in Turkey, a lower mortality from lung cancer in men born in Syria or Lebanon, and a lower mortality from breast cancer in women born in Syria or Lebanon. These differences are interpreted in the light of the available information on dietary habits and reproductive behaviour of Near Eastern migrants in Australia.

Adolescent↗
PubMed2000

The prevalence of factor V R506Q mutation-Leiden among apparently healthy Lebanese.

Resistance to activated protein C (APC) degradation caused by a specific point mutation in the factor V (FV) gene, FV:R506Q or FV-Leiden, which replaces Arg506 with Gln at the APC cleavage site within the FV gene, is the most prevalent inherited caused of venous thrombosis. Recent reports suggested that the prevalence of FV-Leiden is high among Caucasians, and very low among non-Caucasians, thereby suggesting that FV-Leiden has originated as a single event in a primary focus. Insofar as FV-Leiden is associated with increased risk of thromboembolic diseases, coupled with its selective worldwide distribution, the aim of this study was to determine the prevalence of FV-Leiden in Lebanon and compare it with those of other countries of Caucasian and non-Caucasian origin. FV-Leiden was determined by PCR, followed by hybridization with specific wild-type and mutant DNA probes. By screening 174 healthy Lebanese subjects, 25 were shown to carry the FV-Leiden mutation, giving an allele frequency of 7.4% and an overall prevalence rate of 14.4%. Of the 25 FV-Leiden carriers, 24 were in the heterozygous state while one was in the homozygous states. No statistical difference in the FV-Leiden prevalence was noted with respect to age, gender, or sect. In addition to Lebanon, which had the highest prevalence rate reported thus far (14.4%), a high prevalence of FV-Leiden was reported for Syria (13.6%), Greece-Cyprus (13.4%), and Jordan (12.3%), an indication that the Eastern Mediterranean is the primary focus of FV-Leiden mutation. The high prevalence of FV-Leiden in Lebanon suggests that screening for this mutation must be considered for those with a family history, and/or those with additional risk factors for venous thrombosis.

Adolescent↗
PubMed1987

Cholelithiasis in the Syrian population. A prospective study of 189 patients.

A prospective study of 189 Syrian patients with cholelithiasis was performed to throw light on some features of the disease in Syria. Early or emergency cholecystectomies were performed in 28 percent of all operations, whereas elective operations were carried out in the remaining patients. Explorations of the common bile ducts were performed in 34 patients, only 4 of whom had no stones. Wound and chest infections represented the most common postoperative complications. There was only one postoperative death, which was reportedly due to massive hemorrhage from esophageal varices. Analysis of the stones removed after cholecystectomies revealed that 72.4 percent were of mixed composition, 19.4 percent were pure cholesterol, and 8.2 percent were pigmented stones.

Adult↗
PubMed1994

The life and viper of Dr Patrick Russell MD FRS (1727-1805): physician and naturalist.

It is nearly two hundred years since the publication in 1796 of An Account of Indian Serpents collected on the Coast of Coromandel by Patrick Russell. Within the folio is a drawing and description of the venomous snake called Katuka Rekula Poda in the local Telugu language, whose venom was shown experimentally by Dr Russell to be nearly as lethal as that of Cobra de Capello. The snake is now known as Vipera russelli or Russell's viper. Dr Russell was representative of the naturalistic tendency of British medicine in the late 18th century. He was a keen observer and skilled doctor in clinical practice, particularly in Aleppo, Syria, during an outbreak of the plague, and indefatigable in his study of plant and animal life both in Aleppo and later in the Madras Province of India. As a physician as well as Naturalist to the East India Company in the Carnatic he was concerned with the problem of snakebite. His first aim was to find a means whereby the non-specialist could distinguish between poisonous and harmless snakes and so combat the terrible notion that all bites were mortal. His writing, encompassing social and natural histories and climaxed by a study of snakes, has left a rich legacy. Dr Patrick Russell was a man of the highest integrity and ability, a physician and naturalist par excellence.

Animals↗
PubMed1991

Using routine surveys to measure mortality: a tool for programme managers.

Aid donors and recipients have begun to demand timely, population-based information for programme planning and for measuring health programme performance. Results from trials in Jordan, Syria, Djibouti and People's Democratic Republic of Yemen show that widely-used routine surveys for estimating vaccination coverage can be adapted to collect data on health indicators such as child and maternal mortality. Estimation methods must be robust and fieldwork well-supervised. Adding questions about total children ever born and surviving, the survival of the preceding birth, and the survival of sisters to such surveys, population-based estimates of the trend and recent level of childhood mortality and of the lifetime risk of maternal death can be obtained. These trials indicate that the need to monitor selected health indicators could be met through inexpensive, low-technology surveys.

Adult↗
PubMed2005

Syrian women's perceptions and experiences of ultrasound screening in pregnancy: implications for antenatal policy.

Ultrasound scanning is firmly embedded in antenatal maternity care around the world. This paper reports on a qualitative study carried out in 2003 of 30 Syrian women's perceptions and experiences of routine ultrasound in pregnancy. It was part of a larger study of the experiences of pregnancy and childbirth of 500 women from Damascus and its suburbs who had recently given birth to healthy newborns. The women had had multiple scans during pregnancy and accepted its use uncritically nearly all the time. The scans gave them reassurance that the baby was healthy, the pregnancy was progressing well and allowed them to learn the sex of the baby. The women also reacted positively to the antenatal educational messages that were conveyed using scans. However, we found the excessive use of this technology worrying. We believe private doctors, who attend 80% of pregnant women, use ultrasound primarily to attract women to their clinics and increase their income. We recommend that maternity care in Syria should be better regulated; that women and their doctors should be made aware of the essential components of antenatal care; that notional guidelines for antenatol care should be developed and that Syrian women should be empowered to ask questions about pregnancy and childbirth and the care they receive.

Female↗
PubMed2001

Disequilibrium of uranium isotopes in some Syrian groundwater.

Uranium concentration in groundwater samples from three areas of Syria was determined using alpha-spectrometry and INAA. It was in the range of 0-6.13 microg/l in the phosphate areas, and lower than 1 ppb in the volcanic areas. The activity ratio of 234U/238U was investigated, and disequilibrium of uranium isotopes was found to occur (234U/238U = 0.52-2.02). The excess of 234U was calculated. This excess can be interpreted by higher mobility of 234U, which more readily forms the soluble (UO2)2+ ion in comparison with 238U, most of which remains in the insoluble 4+ state. This excess increases with increase in uranium concentration. Thorium concentration was measured using INAA, it was found to be in the rang 0-1.15 microg/l.

Dose-Response Relationship, Radiation↗
PubMed2003

A nonsense mutation in the desmoglein 1 gene underlies striate keratoderma.

Striate keratodermas (PPKS) (OMIM 148700) are a rare group of autosomal dominant genodermatoses characterized by palmoplantar keratoderma typified by streaking hyperkeratosis along each finger and extending onto the palm of the hand. We report a four-generation kindred originating from Iran-Syria in which three members were affected with PPKS. Clinically, these patients present with hyperkeratotic palms and plantar plaques. Direct DNA sequencing analysis revealed a heterozygous C-to-A transversion at nt 395 of the DSG1 gene. This mutation converted a serine residue (TCA) in exon 5 to a nonsense mutation (TAA) designated S132X. The mutation identified in this study is a novel mutation in the DSG1 gene and extends the body of evidence implicating the desmoglein gene family in the pathogenesis of human skin disorders.

Adult↗
PubMed1999

Refractory congenital ascites as a manifestation of neonatal sialidosis: clinical, biochemical and morphological studies in a newborn Syrian male infant.

A Syrian newborn with coarse facies, hepato-splenomegaly, and refractory ascites is reported. Examination of the ascitic fluid showed vacuolated lymphocytes and thin-layer chromatography of urinary oligosaccharides revealed an abnormal pattern indicative of sialidosis. Despite intensive care, the baby died of respiratory insufficiency 28 days after birth. In cultured skin fibroblasts an increase of the incorporation of [14C]methylamine pointed to excessive lysosomal storage and the demonstration of an isolated deficiency of alpha-N-acetylneuraminidase (sialidase) led to the diagnosis of a sialidosis. At postmortem examination, foam cells were found mostly in bone marrow, liver, and brain. To date very few cases of neonatal sialidosis have been reported, and, to the best of our knowledge, this is the first child with neonatal sialidosis from Syria and the first case of neonatal sialidosis studied by the [14C]methylamine incorporation assay.

Ascites↗
PubMed2004

The Arabic Scale of Death Anxiety (ASDA): its development, validation, and results in three Arab countries.

The Arabic Scale of Death Anxiety (ASDA) was constructed and validated in a sample of undergraduates (17-33 yrs) in 3 Arab countries, Egypt (n = 418), Kuwait (n = 509), and Syria (n = 709). In its final form, the ASDA consists of 20 statements. Each item is answered on a 5-point intensity scale anchored by 1: No, and 5: Very much. Alpha reliabilities ranged from .88 to .93, and item-remainder correlations ranged between .27 and .74; the 1-week test-retest reliability was .90 (Egyptians only), denoting high internal consistency and stability. The correlations between the ASDA and Templer's DAS ranged from .60 to .74 denoting high convergent validity of the ASDA against the DAS in the 3 Arab countries. Four factors were extracted in the Egyptian sample and labeled "Fear of dead people and tombs", "Fear of postmortem events", "Fear of lethal disease", and "death preoccupation". The first two factors were almost completely identical in the three countries. The item, "I fear the torture of the grave", had a very high mean score. There were significant correlations between the ASDA and death depression, death obsession, reasons for death fear, and general anxiety, depression, obsession-compulsion, neuroticism, and being a female. All female groups attained significantly higher mean ASDA scores than their male counterparts. Kuwaitis had higher mean ASDA total scores, in comparison with their Egyptian and Syrian counterparts, whereas female Syrians attained the lowest mean ASDA total score in proportion to their female peers.

Adolescent↗
PubMed2005

Are waterpipe users interested in quitting?

Waterpipe smoking has increased dramatically worldwide in recent years, with an estimated 100 million daily users. Research on this traditional Middle Eastern tobacco use method is in its infancy, and little is known about users' cessation-related attitudes and experiences. A random sample of 268 narghile (waterpipe) smokers (40% female; mean age = 30 years; range = 18-68) was obtained from cafes and restaurants in Aleppo, Syria. The majority of users (86.5%) believed they could quit using waterpipes at any time, but that belief was inversely related to perceived dependence, with only 48.7% of those who thought they were "very hooked" believing they could quit. Interest in quitting was expressed by 28.4% of subjects, with the majority (89.2%) reporting health concerns as a primary reason, and 59.2% having made an unsuccessful quit attempt in the past year. In a logistic regression model, independent predictors of interest in quitting included being married, having smoked for fewer years, not increasing the frequency of smoking over time, and having family members who do not smoke a waterpipe and disapprove of its use. Results indicate that a sizable percentage of waterpipe users express interest in quitting and have tried unsuccessfully in the past to quit. Waterpipe use needs to be considered in developing effective tobacco use cessation programs in the Middle East.

Adult↗
PubMed2005

Syrian women's preferences for birth attendant and birth place.

BACKGROUND: Women's preferences for type of maternity caregiver and birth place have gained importance and have been documented in studies reported from the developed world. The purpose of our study was to identify Syrian women's preferences for birth attendant and place of delivery. METHODS: Interviews with 500 women living in Damascus and its suburbs were conducted using a pretested structured questionnaire. Women were asked about their preferences for the birth attendant and place of delivery, and an open-ended question asked them to give an explanation for their preferences. We analyzed preferences and their determinants, and also agreement between actual and preferred place of delivery and birth attendant. RESULTS: Only a small minority of women (5-10%) had no preference. Most (65.8%) preferred to give birth at the hospital, and 60.4 percent preferred to be attended by doctors compared with midwives (21.2%). More than 85 percent of women preferred the obstetrician to be a female. The actual place of delivery and type of birth attendant did not match the preferred place of delivery and type of birth attendant. Women's reasons for preferences were a perception of safety and competence, and communication style of caregiver. CONCLUSIONS: Most women preferred to be delivered by female doctors at a hospital in this population sample in Syria. The findings suggest that proper understanding of women's preferences is needed, and steps should be taken to enable women to make good choices. Policies about maternity education and services should take into account women's preferences.

Adult↗
PubMed2002

Disparities in self reported oral health problems among a young Syrian adult population.

OBJECTIVE: To describe the prevalence of dental pain and other oral health problems among a young Syrian adult population and to identify socio-demographic factors associated with these experiences. SUBJECTS: An industrial sample of 400 men and women aged 18-34 years from Damascus, Syria. METHODS: Study participants were interviewed about their experience of oral health problems in the previous year (1998). Socio-demographic information was collected. RESULTS: 93% (369) of the interviews were completed. The prevalence of oral health problems was high, with 96% (353) of respondents claiming that they experienced one or more problems in the previous year. Two thirds of participants (65%, 239) claimed they had dental pain in the previous year. Analysis revealed that dental pain experience was significantly associated with age and gender. Analysis considering all factors revealed that the odds of experiencing dental pain were higher amongst the younger age group (18-24 compared to 25-34 year-olds). CONCLUSION: The prevalence of oral health problems was high among the population studied. Socio-demographic variations in experience of dental pain were apparent, with young men of lower education having the greatest odds of dental pain experience in the previous year.

Adolescent↗
PubMed2005

Extent of exposure to environmental tobacco smoke (ETS) and its dose-response relation to respiratory health among adults.

BACKGROUND: There is a dearth of standardized studies examining exposure to environmental tobacco smoke (ETS) and its relationship to respiratory health among adults in developing countries. METHODS: In 2004, the Syrian Center for Tobacco Studies (SCTS) conducted a population-based survey using stratified cluster sampling to look at issues related to environmental health of adults aged 18-65 years in Aleppo (2,500,000 inhabitants). Exposure to ETS was assessed from multiple self-reported indices combined into a composite score (maximum 22), while outcomes included both self-report (symptoms/diagnosis of asthma, bronchitis, and hay fever), and objective indices (spirometric assessment of FEV1 and FVC). Logistic and linear regression analyses were conducted to study the relation between ETS score and studied outcomes, whereby categorical (tertiles) and continuous scores were used respectively, to evaluate the association between ETS exposure and respiratory health, and explore the dose-response relationship of the association. RESULTS: Of 2038 participants, 1118 were current non-smokers with breath CO levels < or = 10 ppm (27.1% men, mean age 34.7 years) and were included in the current analysis. The vast majority of study participants were exposed to ETS, whereby only 3.6% had ETS score levels < or = 2. In general, there was a significant dose-response pattern in the relationship of ETS score with symptoms of asthma, hay fever, and bronchitis, but not with diagnoses of these outcomes. The magnitude of the effect was in the range of twofold increases in the frequency of symptoms reported in the high exposure group compared to the low exposure group. Severity of specific respiratory problems, as indicated by frequency of symptoms and health care utilization for respiratory problems, was not associated with ETS exposure. Exposure to ETS was associated with impaired lung function, indicative of airflow limitation, among women only. CONCLUSIONS: This study provides evidence for the alarming extent of exposure to ETS among adult non-smokers in Syria, and its dose-response relationship with respiratory symptoms of infectious and non-infectious nature. It calls for concerted efforts to increase awareness of this public health problem and to enforce regulations aimed at protecting non-smokers.

Adolescent↗
PubMed2006

In vitro susceptibilities of Brucella melitensis isolates to eleven antibiotics.

BACKGROUND: Brucellosis is an endemic disease present in many countries worldwide, but it is rare in Europe and North America. Nevertheless brucella is included in the bacteria potentially used for bioterrorism. The aim of this study was the investigation of the antibiotic susceptibility profile of brucella isolates from areas of the eastern Mediterranean where it has been endemic. METHODS: The susceptibilities of 74 Brucella melitensis isolates derived from clinical samples (57) and animal products (17) were tested in vitro. The strains originate from Crete (59), Cyprus (10), and Syria (5). MICs of tetracycline, rifampicin, streptomycin, gentamicin, norfloxacin, ciprofloxacin, levofloxacin, trimethoprim/sulfamethoxazole, ampicillin, amoxicillin/clavulanic acid, and erythromycin were detected by E-test method. The NCCLS criteria for slow growing bacteria were considered to interpret the results. RESULTS: All the isolates were susceptible to tetracycline, streptomycin, gentamicin, ciprofloxacin, norfloxacin, and levofloxacin. Two isolates presented reduced susceptibility to rifampicin (MIC value: 1.5 mg/l) and eight to SXT (MIC values: 0.75-1.5 mg/l). Erythromycin had the highest (4 mg/l) MIC90value and both norfloxacin and erythromycin the highest (1.5 mg/l) MIC50 value. CONCLUSION: Brucella isolates remain susceptible in vitro to most antibiotics used for treatment of brucellosis. The establishment of a standardized antibiotic susceptibility method for Brucella spp would be useful for resistance determination in these bacteria and possible evaluation of bioterorism risks.

Animals↗