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PubMed2002

Diet and prevention of coronary heart disease in the Arab Middle East countries.

The picture of health and nutritional status in the Arab Middle East countries has changed drastically during the past four decades as a result of changes in dietary habits, socio-economic situation and lifestyle. The chronic non-communicable diseases such as coronary heart disease (CHD), diabetes, hypertension and cancer have become the main public health problems in most of these countries. Pattern of food consumption may play an important part in the increasing incidence of CHD in this region. The traditional diet, characterized by a high-fiber content and low in fat and cholesterol has changed to a more westernized diet with high content of fat, free sugars, sodium and cholesterol. Daily per capita fat supplies showed an impressive increase in most of these countries, ranging from 13.6% in Sudan to 143.3% in Saudi Arabia. A high intake of cholesterol is reported in some of these countries. Also, the consumption of fiber-rich foods such as whole grains, vegetables and fruits is low. Data from food composition tables in the region showed that sodium content in the Arab Middle East diet is high. Dietary guidelines and recommendations for the prevention and control of chronic diseases, including CHD, in these Arab countries are provided.

Coronary Disease↗
PubMedDate not supplied

Urbanization and social change in the Arab world.

"... This paper represents an exploratory essay that looks at variations (variables) within the Arab region over time and space and that attempts to extract some of the underlying common elements that distinguish present day social change and urbanization in the Arab world." A typology is developed that identifies sub-types of Arab countries on the basis of economic structure. Major categories include heartland/confrontation states, neocolonial dependencies, semi-oil states, and oil-wealthy states.

Africa↗
PubMed1993

International cooperation of Japanese pediatricians with Cairo University Pediatric Hospital.

In connection with 'Child Year' in 1980, an agreement on the construction and donation of a pediatric hospital was concluded between the Egyptian and Japanese Governments. Under this agreement, the Cairo University Pediatric Hospital (CUPH) was opened in March 1983, as a four-storey building with 240 beds, and including four operating rooms, an intensive care unit (ICU) and neonatal ICU. The technical cooperation and supply of medical equipment in all areas of CUPH is ongoing during this project. The subject matter of technical cooperation is as follows. (1) Dispatch of Japanese experts to Egypt for short and long terms. (2) Acceptance of Egyptian trainees to Japan. (3) Supply of medical equipment and materials. Through the first 5 years of this cooperation, the management of ICU, operating theaters, medical and surgical wards has improved markedly with great efforts from the Egyptian and Japanese staff. Based on this successful cooperation, the Pediatric Cardiovascular Center was established in 1988 with a two-storey extension in the hospital including two cardiac operation theaters, ICU and other special facilities. Now, CUPH has become the center of pediatric medical care in not only Egypt but also the surrounding Arabic countries, supported by the friendly and close relationship between Egypt and Japan.

Child↗
PubMed2001

Ethnic differences in self reported health in Malmö in southern Sweden.

STUDY OBJECTIVE: The aim of this study was to investigate ethnic differences in self reported health in the city of Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions. DESIGN/SETTING/PARTICIPANTS: The public health survey in Malmö 1994 was a cross sectional study. A total of 5600 people aged 20-80 years completed a postal questionnaire. The participation rate was 71%. The population was categorised according to country of origin: born in Sweden, other Western countries, Yugoslavia, Poland, Arabic speaking countries and all other countries. The multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the differences by country of origin in self reported health. Finally, variables measuring psychosocial and economic conditions were introduced into the model. MAIN RESULTS: The odds ratios of having poor self reported health were significantly higher among men born in other Western countries, Yugoslavia, Arabic speaking countries and in the category all other countries, as well as among women born in Yugoslavia, Poland and all other countries, compared with men and women born in Sweden. The multivariate analysis including age and education did not change these results. A huge reduction of the odds ratios was observed for men and women born in Yugoslavia, Arabic speaking countries and all other countries, and for women born in Poland after the introduction of the social network, social support and economic factors into the multivariate model. CONCLUSIONS: There were significant ethnic group differences in self reported health. These differences were greatly reduced by psychosocial and economic factors, which suggest that these factors may be important determinants of self rated health in certain minority groups.

Adult↗
PubMed1994

Congenital toxoplasmosis among premature infants with different clinical pictures in Saudi Arabia.

No doubt, toxoplasmosis is a prevalent infection in all the Arab countries. However, the incidence differs from one country to another and even within the same country. Congenital toxoplasmosis is the most important form of the infection. In the present study, some 78 premature infants with different clinical pictures were examined for Toxoplasma IgG (by IHAT and ELISA) and Toxoplasma IgM (by ELISA). The results showed Toxoplasma IgG ranging between 32.1% (IHAT) and 46.2% (ELISA) while IgM (ELISA) was 23.1%. The highest positivity rate was among those suffering jaundice and the lowest was among those suffering fever of unknown origin. Protection of women particularly pregnant ones, from Toxoplasma infection is a must.

Animals↗
PubMed2004

Translating medical journals into Arabic. JAMA Middle East as an example.

JAMA Middle East has distributed monthly 25,000 issues into 14 Arab countries since 1991. Translating the original articles into Arabic was considered as the license permits translation. The number of Arab physicians exceeds 250,000, but those who studied medicine in Arabic are very few. Adequate translators and other publishing staff are lacking. Advertisers will not invest in journals without readership. The other 13 international editions of JAMA publish in their national languages, so do their medical schools. Teaching medicine in a foreign language did not bring leadership to Arab medicine. It is just another indicator of Arab underdevelopment. There is growing support to shift the language of medical teaching into Arabic, but the only practical step has been the Unified Medical Dictionary.

American Medical Association↗
PubMed2006

Genotypes of hepatitis C virus (HCV) among positive Lebanese patients: comparison of data with that from other Middle Eastern countries.

Recently we identified hepatitis C virus (HCV) genotype 4 as the principle genotype among Lebanese thalassaemics. In an attempt to confirm the predominance of genotype 4 in Lebanon and perhaps in the Middle East, genotyping was attempted on 142 HCV-infected Lebanese patients from five different hospitals in the country. These included 38 HCV-positive patients with symptomatic liver disease who were referred to gastroenterologists and 104 HCV-positive patients with no symptoms of liver disease: 27 patients with thalassaemia, 30 patients on haemodialysis, 32 multi-transfused and 15 intravenous drug users. HCV genotyping was performed on PCR HCV RNA-positive samples using a commercial line probe assay (LiPA; Innogenetics, Ghent, Belgium). HCV genotype 4 is found to be the predominant genotype among HCV-infected Lebanese patients (ranging from 34.2% to 53.3%) followed by 1a (ranging from 12.5% to 43.3%) and 1b (ranging from 8.0% to 34.4%). In patients with symptomatic liver disease, however, genotype 4 (34.2%) was preceded by genotype 1a (39.5%). The predominance of HCV genotype 4 in our population (45.7%) confirms the predominance of HCV genotype 4 in Lebanon and most of the Arab countries in the Middle East but contrasts with data reported from non-Arab Middle Eastern Countries as can be seen from the literature review. Implications of genotyping for clinical outcome of HCV infection, response to treatment as well as for vaccine development are discussed.

Adult↗
PubMed2005

Epidemiology of type I diabetes mellitus among Arab children.

In this article, the epidemiology of type 1 diabetes mellitus among Arab children (<15 years) living in Arab and non-Arab countries is reviewed. These data include the incidence, prevalence and etiopathogenic factors including genetics, environmental factors as well as autoimmune disease markers aside from clinical presentation at onset. The review is based on the information from publications in the international literature identified by searching Medline, other websites as well as personal experience and some communications. The obtained data suggest that the incidence of type 1 diabetes in these countries is increasing similar to the experience in other parts of the world. High incidence has been reported among Arab children who immigrated to some Western countries. The highest incidence is in Qatar and Kuwait and the lowest is in Oman and Jordan. There is considerable variation among countries, which could not be explained on genetic or climatic variations alone. Other environmental factors particularly nutritional ones including high intake of dairy products and vitamin D deficiency are possibly operating. Further, nationwide research from different countries covering the rural as well as urban areas and different ethnic intermixes are needed. To overcome financial and facility problems that hinder research; some cooperation between these countries as well as international bodies are needed.

Arabs↗
PubMed2002

Early childhood caries and risk factors in Jordan.

OBJECTIVE: To describe the prevalence of dental caries among Jordanian preschool children and risk factors for caries. DESIGN: Preschool children aged 1 to 5 years from randomly selected nurseries and kindergartens in Amman were surveyed in September 2001. A questionnaire to investigate factors that might have affected dental caries level was completed by parents. Dental caries was diagnosed as recommended by the World Health Organization. RESULTS: The mean dmft scores at 1, 2, 3, 4, and 5 years were 0.19, 1.15, 1.7, 2.13, and 3.22 respectively. Overall, 52% of children were caries-free. Caries level was significantly related to feeding practices, snacking habits, oral health practices and pattern of dental visiting as well as to socio-economic background, parents, education level and awareness. CONCLUSION: The dental caries level was slightly higher than that of children in industrialised countries but lower than that of children in the neighbouring Arab countries. However, the early caries development seen in children from the lower socio-economic classes, because they are at high risk for caries in Jordan, reinforces the need for preventive programmes before eruption of the teeth. Access to dental care must be improved to enable any preventive strategies to be implemented.

Analysis of Variance↗
PubMed2004

Dementia in Qatar.

OBJECTIVE: Dementia is a major public health problem among the elderly in developed countries and a growing problem in the underdeveloped countries. There are no published data on dementia in any of the Arabic countries. The aim of this study was to determine the different sub-types of dementia among Qataris. METHODS: A retrospective and prospective ongoing hospital-based study in which all medical records of the patients with diagnosis of dementia seen at the Hamad General Hospital, Doha, Qatar, between June 1997 and June 2003, whether inpatient or outpatient were reviewed. Dementia was defined according to diagnostic and statistical manual (DSM) IV criteria. Those who had dementia were evaluated by a psychologist, psychiatrist, neurologist and a geriatrician. All had brain computerized tomography, magnetic resonance imaging or both and routine blood tests. Finally, they were classified into sub-types according to the cause of dementia. RESULTS: Out of 300 patients, 134 fulfilled the inclusion criteria, most of them were illiterate, married and non-smokers. Among those dementia sub-types were: Alzheimer disease (AD) 39 (29%), vascular dementia (VaD) 30 (22%), mixed AD and VaD 20 (15%) and Parkinson's disease with dementia 8 (6%) were noted. The rest of them had dementia due to other medical conditions. CONCLUSION: Our study showed that AD is more prevalent than VaD. It also showed that patients and their families seek medical help late due to the general belief among the public that forgetfulness and other associated cognitive impairment are part of the normal aging process. The emergence of new drugs and advancement in the prevention of cerebrovascular diseases makes early diagnosis of dementia sub-type important. A community based study, to show the real prevalence and incidence of sub-types of dementia, is highly indicated. These data are necessary for planning and setting up community services and health care programs for demented patients.

Age Distribution↗
PubMedDate not supplied

A multicenter clinical trial in the Arab world.

Financial, social, and perhaps religious, ethical, and other factors hinder investment and performance of clinical research in Arab countries. We report in that conducting multicenter clinical trials is feasible in the Arab world, describing our experience in planning and conducting one of the first multicenter, multinational, clinical trials in the region. A multicenter clinical trial sought to document the efficacy and safety of Epotin for the treatment of anemia in patients on maintenance hemodialysis. Among 29 centers contacted for participation, a positive response was obtained from 17 (62%) located in eight countries. The initial recruitment period of 3 months was extended to 1 year. Among the participating centers, 16 forwarded their results in time, with one being late. There were minor and a few major protocol violations, the latter requiring exclusion of data from the final analysis. Sponsorship was mainly by a local pharmaceutical company (Julphar). A co-coordinating body was crucial to trace and gather the data. Since conduct of the trial required considerable time and effort from investigators, the use of modern information technology could have reduced the effort and improved the outcomes. We conclude that multicenter clinical trials, which are essential can be conducted in this region. This experience needs to be repeated and refined.

Anemia↗
PubMed2003

Biomedical research in developing countries: the case of Morocco in the 1990s.

Moroccan biomedical research occupies the third place among African or Arab countries, and its outputs considerably increased during the last decade. The quality of publications from developing countries should be improved as suggested by the comparison with developed countries. The gap between developed and developing countries is very large considering the number of publications and their quality, the number of edited journals, and the number of patented inventions, thus making developing countries more as consumers then producers. Accordingly, there is a large gap between developing and developed countries when considering the human and financial resources devoted to scientific research.

Bibliometrics↗
PubMed1997

Surgery in Israel.

The evolution and development of surgery in Israel reflects the influence of its dramatic historical events. The immigration of surgeons, particularly since the fourth decade of the 20th century, highly contributed to the framework of modern surgery. Medical education occurs at 4 medical schools, in Jerusalem, Tel Aviv, Haifa, and Beer Sheva, and postgraduate surgical training takes place in all public hospitals, most of which are university hospitals or have university-affiliated departments, and is controlled by the Scientific Council of the Israel Medical Association (Tel Aviv). Health care is provided by 4 health insurance funds and has been recently influenced by the National Health Insurance Bill and the Bill of Patient's Rights. Surgical standards are high and similar to the very best of Western countries. The geographical location of Israel in the Middle East, surrounded by hostile Arab countries, has dramatically influenced the development of Israeli surgery. The practice of surgery ranges from full-time service in state and insurance-funded mostly academic hospitals, to private part-time clinics for wealthy and insured patients. Surgical training occurs only in departments accredited by the Scientific Council, which are mostly affiliated with the 4 medical schools. A surgical residency in Israel usually requires 6 years, and its guidelines and regulations are elaborated and recommended by the Israel Surgical Society and controlled by the Scientific Council. Most Israeli surgeons were trained in Israeli hospitals, but a substantial number of surgeons immigrated to the country, especially from eastern Europe.

Curriculum↗
PubMed1981

[Cardiovascular risk factors in headquarters staff of the World Health Organization].

Analysis of 2333 medical files of the World Health Organization's headquarters staff in Geneva gives insight into the epidemiology of cardiovascular risk factors in nationals originating from 67 different countries but living in the same environment. The study confirms well established facts such as the prevalence of hypertension (HT) with respect to sex, age, and period of observation, its consequences and interrelation with high cholesterol levels, diabetes, and obesity. The importance of a medical service with emphasis on prevention is stressed. Major differences in relation to geographic origin are noted for men. The highest percentage of HT (32%) is noted for staff members from Germanic countries. There is a concentric decrease according to nationality: 29 to 25% for the other countries of Central, Western, and Southern Europe, 23 to 18% for the USSR, Arab countries and North America, 9 to 6% for South East and Eastern Asia and African countries south of the Sahara (p less than 0.05 between the extremes). India and Australia do not fit the pattern of concentric decrease, since a high percentage of men in those countries have HT. As the number of files available was insufficient to carry out the same analysis for women or to determine other factors of cardiovascular risk, the study will be extended to cover the staff of other International Organizations in Geneva.

Age Factors↗
PubMed1993

[Hydatid disease in Israel].

The prevalence pattern of hydatid disease (echinococcosis) in Israel has changed during the past 40 years. Until 1948 it was mainly common in the non-Jewish community; after 1948 its prevalence was high in Jews who immigrated to Israel from Arab countries; and since 1967 endemicity has gradually increased in some rural and semirural Arab and Druze communities. Of 224 surgically-confirmed cases of hydatid disease from these communities during 1960-1989, 52 were from Yirka, a Druze community with a population of 8200. In that town 8% of 63 dogs tested after an arecoline purge and 10% of 255 sheep at the local abattoir were found to be infected. Randomized serosurvey of 758 inhabitants indicated a 1.6% cumulative percentage of hydatid infections, leading to an extrapolated rate of 1583/100,000. Yirka thus is one of the most highly endemic areas for hydatid disease in the world.

Animals↗
PubMed1991

The epidemiology of echinococcosis in Israel.

Shifts in population and employment patterns in Israel since 1948 have been accompanied by profound changes in the distribution of echinococcal disease. Formerly, it was most commonly imported with the mass immigration of Jews after 1948 from the Arab countries of North Africa and Asia Minor, and appeared to be relatively uncommon in Israel-born Jews and Arabs. In 1980 the disease was made notifiable, and this paper presents a review of the years 1981-1989. The prevalence pattern that prevailed after the end of mass immigration has reversed so that cases are now twice as common in Arabs as in Jews. Among the Arabs the disease appears most commonly in the north of the country, especially among the Druze, less commonly among Christians and least in Muslims. We suggest that this prevalence pattern is related largely to home slaughter of sheep, to differing attitudes to dogs, and possibly also to the hunting of wild pig. Targetted education and better enforcement of existing regulations can lead to a reduction in disease.

Adolescent↗
PubMed2003

Deniz: the electronic database for beta-thalassemia mutations in the Arab world.

OBJECTIVE: Data on the distribution of beta-thalassemia mutations in Arab populations are usually destined to disparate locations and much of these become increasingly difficult for an average researcher to locate. That is why we aimed at establishing an electronic database network, called Deniz, for beta-thalassemia allele frequency distributions in the Arab world at http://biobase.fatih.edu.tr. METHODS: The scheme of the database combines the benefits of the relational and hierarchical systems. Detailed statistics of the frequencies of beta-thalassemia mutations are retrieved in tabular forms. Multiple permanent connections allow flexible movement within the database. Queries are processed by the systems language and sent to the user's browser as hypertext markup language documents. RESULTS: The database catalogues the frequencies of beta-thalassemia mutations in 14 Arab countries as pooled from the analysis of 3,138 chromosomes by 36 laboratories. Of the 57 B-globin gene mutations reported in Arabs, IVS-I-110 (G-A), IVS-I-5 (G-C), IVS-I-6 (T-C), IVS-II-1 (G-A), and IVS-I-1 (G-A) are the most encountered and they account for approximately two thirds of the Arab chromosomes registered in Deniz. CONCLUSION: In addition to its importance as a hub of updated information on the distribution of beta-thalassemia mutations in Arabs, information in Deniz may be used to predict diagnostic strategies that may be offered to natives of unstudied countries. Incidence data may also give important clues on the possible origins of beta-thalassemia in the Arab world. The integration of Deniz with other databases is currently in process and researchers are invited to contribute to the growth of the database.

Alleles↗