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Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men.

UNLABELLED: OBJECTIVE; To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and prostate volumes in a population of healthy Arab men. SUBJECTS AND METHODS: Blood samples were taken from 396 healthy Arab men (from Kuwait and Oman) aged 15-79 years and from across the social spectrum. Men aged >40 years had a digital rectal examination and transrectal ultrasonography of the prostate to determine prostate volume. The serum PSA level was measured using commercial kits, and age-specific ranges for PSA levels and prostate volume determined. RESULTS: The serum PSA ranges (ng/mL) for each age range in Arab men were: 40-49 years, 0-0.9; 60-69, 0-2.7; 70-79, 0-5.5 ng/mL; the respective prostate volumes were 8-22, 9-30 and 10-33 mL. The serum PSA level and prostate volume correlated with age (P < 0.001). Arab men had lower serum PSA levels and prostate volumes than those reported for Caucasians, but similar to those reported for Asians (Japanese and Chinese). CONCLUSION: These results indicate that Arab men have lower PSA levels and prostate volumes than Caucasians. The levels are slightly lower than those reported in the Japanese and, as in the Japanese, low PSA levels and small prostate volumes might be related to the low incidence of clinical prostate cancer in Arab men.

Adolescent↗

Prevalence of viral markers among first-time Arab blood donors in Kuwait.

BACKGROUND: The aim of this study was to assess the effect of blood donation modes on the prevalence of viral markers among Arab first-time blood donors in Kuwait. STUDY DESIGN AND METHODS: Donor ethnic background was classified as Kuwaiti nationals and non-Kuwaiti Arabs. A total of 26,874 donors were screened in 2002 for the following viral markers: hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc), human immunodeficiency virus-1 and -2 antibody (anti-HIV-1 and -2), HIV p24, and human T lymphotropic virus-I and -II antibody (anti-HTLVI/II). All samples positive for the presence of anti-HBc were tested for anti-HBs. Among these donors, 12,798 were first-time donors of which 74 percent were replacement and 26 percent were volunteers. RESULTS: The prevalence of HCV among replacement donors was significantly higher than the volunteer group. The difference between the two modes of blood donations, however, was not significant for HBsAg. The prevalence of anti-HCV among Kuwaiti national and non-Kuwaiti Arab first-time donors was 0.8 and 5.4 percent, respectively, whereas the prevalence of HBsAg was 1.1 and 3.5 percent, respectively, with the difference being significant at a p level of <0.0001. The difference observed for prevalence of anti-HBc among Kuwaiti national and non-Kuwaiti Arab donors (17 and 33.3%, respectively) was significant (p < 0.0001). Among first-time donors, 13.7 percent were positive for the presence of anti-HBs, indicating that 13.7 percent of the total Arab donor population might have had a previous infection and possible immunity to hepatitis B virus (HBV). CONCLUSION: A high prevalence of HBV and HCV was found among non-Kuwaiti Arab donors. The prevalence of anti-HCV was only significantly higher among replacement versus volunteer first-time donors. Therefore, there is a need to develop a strategic plan that incorporates the diverse background of the blood donors living in Kuwait.

Adult↗

Association of the MIC-A gene and HLA-B51 with Behçet's disease in Arabs and non-Ashkenazi Jews in Israel.

BACKGROUND: Behçet's disease is known to be strongly associated with HLA-B51 in many different ethnic groups. Recently, it was suggested that MIC-A (major histocompatibility complex class I related gene A) is the pathogenic gene after strong association was found between the MIC-A A6 allele of the transmembrane region and the disease in Japanese and Greek patients, although in Greek patients this association was found to be due to linkage disequilibrium with HLA-B51. OBJECTIVES: To investigate microsatellite polymorphism in Arab and non-Ashkenazi Jewish (NAJ) patients in Israel, to determine whether this association occurs in these groups with Behçet's disease, and elucidate the associated HLA allele of the disease. METHODS: Forty four Israeli patients with Behçet's disease, including 20 Arabs and 24 NAJ, and 130 ethnically matched healthy controls were examined for MIC-A microsatellite polymorphism of the transmembrane region using polymerase chain reaction, autoradiography, and sequence analysis. RESULTS: The MIC-A A6 allele was significantly more frequent in the Arab patient group (19/20 (95%)) than in healthy Arab controls (25/42 (60%)) (p(corr)=0.015, OR=12.92), but not in the NAJ patients (16/24 (67%)) compared with NAJ healthy controls (48 /88 (55%)) (p(corr)=1.02, OR=1.667). In stratification analysis of the Arab subgroup, on the confounding effect of MIC-A A6 on HLA-B51 association and vice versa, Behçet's disease was distinctly associated only with HLA-B51. CONCLUSIONS: These results imply strong association between the MIC-A A6 allele and the disease in Israeli Arabs, but not in Israeli NAJ patients. The stratification analysis indicates that this association results secondarily from a strong linkage disequilibrium with HLA-B51, and the real disease susceptibility gene which plays a part in the development of Behçet's disease is most probably the HLA-B51 allele itself.

Arabs↗

Autosomal recessive disorders among Arabs: an overview from Kuwait.

Kuwait has a cosmopolitan population of 1.7 million, mostly Arabs. This population is a mosaic of large and small minorities representing most Arab communities. In general, Kuwait's population is characterized by a rapid rate of growth, large family size, high rates of consanguineous marriages within the Arab communities with low frequency of intermarriage between them, and the presence of genetic isolates and semi-isolates in some extended families and Bedouin tribes. Genetic services have been available in Kuwait for over a decade. During this time it has become clear that Arabs have a high frequency of genetic disorders, and in particular autosomal recessive traits. Their pattern is unique and some disorders are relatively common. Examples are Bardet-Biedl and Meckel syndromes, phenylketonuria, and familial Mediterranean fever. A relatively large number of new syndromes and variants have been delineated in Kuwait's population, many being the result of homozygosity for autosomal recessive genes that occurred because of inbreeding. Some of these syndromes have subsequently been found in other parts of the world, negating the concept of the private syndrome. This paper provides an overview of autosomal recessive disorders among the Arabs in Kuwait from a personal perspective and published studies, and highlights the need for genetic services in Arab countries with the goal of prevention and treatment of genetic disorders.

Chromosome Aberrations↗

Internet-based search of randomised trials relevant to mental health originating in the Arab world.

BACKGROUND: The internet is becoming a widely used source of accessing medical research through various on-line databases. This instant access to information is of benefit to busy clinicians and service users around the world. The population of the Arab World is comparable to that of the United States, yet it is widely believed to have a greatly contrasting output of randomised controlled trials related to mental health. This study was designed to investigate the existence of such research in the Arab World and also to investigate the availability of this research on-line. METHODS: Survey of findings from three internet-based potential sources of randomised trials originating from the Arab world and relevant to mental health care. RESULTS: A manual search of an Arabic online current contents service identified 3 studies, MEDLINE, EMBASE, and PsycINFO searches identified only 1 study, and a manual search of a specifically indexed, study-based mental health database, PsiTri, revealed 27 trials. CONCLUSION: There genuinely seem to be few trials from the Arab world and accessing these on-line was problematic. Replication of some studies that guide psychiatric/psychological practice in the Arab world would seem prudent.

Arab World↗

Validation of the Arabic versions of the thirty- and twelve-item General Health Questionnaires in primary care patients.

BACKGROUND: The aim of this study was to investigate the validity of the Arabic versions of the GHQ-30 and GHQ-12 in a sample of primary health care (PHC) patients in Al Ain, United Arab Emirates. METHOD: A randomly selected sample (n = 157) of patients attending a PHC centre in Al Ain was screened using the Arabic version of the GHQ-30, the first 12 items of which constitute the GHQ-12. Then a standardised clinical interview using the Clinical Interview Schedule (CIS) was conducted with all screened patients. The receiver operating characteristic analyses of the Arabic versions of both GHQ-30 and GHQ-12 were compared and their correlation coefficients with the weighted total score of the CIS and the overall severity rate were estimated. Discriminant functional analysis was also performed to assess the discriminatory powers of both the GHQ-30 and GHQ-12. RESULTS: Using the simple Likert scoring method, the best cut-off point of the GHQ-30, that balances between sensitivity and specificity, was 31/32 with a sensitivity of 0.83 and specificity of 0.83, and that of the GHQ-12 was 12/13 with a sensitivity of 0.83 and specificity 0.80. The total discriminatory powers of the GHQ-30 and GHQ-12 were approximately 93 and 86%, respectively. Both versions of the GHQ were found to have a significant concurrent validity. CONCLUSION: The Arabic versions of both GHQ-30 and GHQ-12 are valid psychiatric screening instruments, with almost similar performance, for Arabic-speaking PHC patients.

Adult↗

Interaction of gum arabic, maltodextrin and pullulan with lipids in emulsions.

The interaction of gum arabic, maltodextrin and pullulan with lipids in emulsion systems was investigated. Interfacial tension and interfacial viscosity measurements revealed that only gum arabic could adsorb and form a viscoelastic film at the oil-water interface. Good emulsifying activity was demonstrated for gum arabic, whereas fine emulsions could not be produced from the other polysaccharide solutions and oil. Frequency-dependent increases in the storage and loss moduli were observed for all the polysaccharide solutions. Such rheological behavior did not substantially change when maltodextrin and pullulan were mixed with oil to form emulsions. However, the frequency-dependence of the dynamic moduli disappeared in the gum arabic-stabilized emulsion, suggesting the formation of a network structure in which oil droplets could form junctions with gum arabic chains. The results on the inhibition of lipid oxidation by polysaccharides suggest that gum arabic protected lipids from the attack of lipoxygenase and free radicals by adsorbing at the oil droplet surface.

Elasticity↗

HLA-B27 in healthy adults in UAE. An extremely low prevalence in Emirian Arabs.

We reviewed the prevalence of HLA-B27 in 760 healthy individuals in the UAE, where the community is multi-ethnic. All were potential live donors for renal and bone marrow transplantation. The overall prevalence rate was 6.4%; 5.7% in Arabs only and 7.4% in the Asian group. Significant intra-racial variation were not observed between the major ethnic groups (P 0.235 and 0.1). Emirian Arabs exhibited a very low prevalence rate of 0.5% which was highly significant in comparison to other Arab subgroups, thus allowing a degree of intra-racial variations of the marker. The pair-wise comparison in all other Arab subgroups did not yield any significant differences. The Yemeni Arabs in this study had the highest rate of 17% and unexpectedly, Arabs with an African admixture (Somalis and Sudanese) also showed relatively high figures.

Adult↗

The frequency of 14 beta-thalassemia mutations in the Arab populations.

The beta-thalassemias are a heterogeneous group with respect to molecular pathogenesis, and different populations and ethnic groups differ with respect to the predominating mutations. This variable spectrum of beta-thalassemia mutations has resulted in extensive studies in each population and ethnic group to identify the major mutations. In this study we investigated the prevalence of 14 mutations in 253 beta-thalassemia patients drawn from eight Arab countries (i.e. Jordan, Egypt, Syria, Lebanon, Yemen, and Saudi Arabia), living in Saudi Arabia and attending Ministry of Health hospitals. The mutations investigated included IVS-I-110 (G-->A), IVS-II-1 (G-->A), IVS-I-5 (G-->C), codon 39 (C-->T), IVS-I-1 (G-->A), frameshift at codons 8/9 (+G), frameshift at codons 41/42 (-TTCT), codon 15 (TGG-->TAG), IVS-I-6 (T-->C), frameshift at codon 16 (-C), IVS-II-745 (C-->G), codon 6(-A), IVS-I, 3' end (-25 bp), and Cap +1 (A-->C). The most frequently encountered mutations were IVS-I-110 and IVS-II-1 which were identified in the population of each Arab country. The IVS-I-1 and IVS-II-745 mutations were encountered in Jordanians, Egyptians, and Syrians. The IVS-I-5, codon 39, codon 6, IVS-I, 3' end (-25 bp), and Cap +1 mutations were encountered only in Saudis and not in other Arabs, except codon 39 which was present in the Syrians and Lebanese. Other mutations were generally rare and not specific to any Arab ethnic group. This paper presents preliminary data on the prevalence of 14 mutations in the Arab populations and shows wide variation in the molecular basis of beta-thalassemia in different Arab ethnic groups. Further detailed studies to identify the entire spectrum of beta-thalassemia mutations are stressed.

Arabs↗

Ethnic differences in cigarette smoking among adolescents: a comparison of Jews and Arabs in Jerusalem.

BACKGROUND: Prevention of cigarette smoking is an important issue in public health policy. Since most adult smokers began smoking in childhood, understanding behavorial factors associated with smoking initiation would contribute to smoking initiation programs. Health-related behavior may vary between different ethnic groups. OBJECTIVES: To determine the prevalence of smoking among Jewish and Arab adolescents in Jerusalem, and whether there are differences in smoking initiation between the two ethnic groups. METHODS: We carried out a cross-sectional survey of all students in the 6th to 11th grades (age range 11-17 years) of a Jewish school and an Arab school in the Jerusalem area, using an anonymous self-completion questionnaire. A total of 791 questionnaires was analyzed, 479 from the Jewish students and 312 from the Arab students. RESULTS: The lowest prevalence of smoking was found among Arab female students and the highest among Jewish female students (9% vs. 41%, P < 0.001). The prevalence of smoking among Jewish and Arab males was similar. More Arab female students smoked than their mothers. Peer pressure seemed to be a more important factor among Jewish students. CONCLUSIONS: This study demonstrated the presence of ethnic differences in smoking prevalence and the reasons for smoking among adolescents in Israel. These results suggest the need for specific smoking prevention policies for different ethnic groups.

Adolescent↗

Nutritional risk factors and breast cancer in Jewish and Arab women.

Based on a lower reported incidence of breast cancer in the Arab population in Israel, nutritional levels were evaluated in a case-control study of 33 Jewish and 10 Arab patients with breast cancer all matched with a first-degree family-related control. Demographic, gynecologic, obstetric, anthropometric, genetically tumor-related, and nutritional data were ascertained through interviews, tests, and questionnaires. Food consumption, calories, protein, fat, and fiber intake, and anthropomorphic measures were calculated. The following results were obtained: 1. Calories of food consumption were significantly higher in Jewish and Arab patients than in their controls. 2. Jewish patients consumed significantly higher levels of monounsaturated fat; Arab patients consumed significantly higher levels of dietary fiber. 3. Animal protein intake was elevated in patients of both ethnic origins as compared with controls. 4. Vegetable fat and monounsaturated fatty acids were elevated in Arab patients as compared with Jewish patients. 5. Body weight of both Arab and Jewish patients was not significantly higher when compared with their controls. 6. Energy consumption and obesity were higher in breast cancer patients than in the controls. This supporting evidence suggests an association between obesity and breast cancer occurrence.

Adult↗

The Arabic ICIQ-UI SF: an alternative language version of the English ICIQ-UI SF.

AIMS: Urinary incontinence (UI) is a common and distressing condition. A variety of questionnaires are currently available to assess UI and its impact on patients' lives. However, most have not been adapted for international use. Following a systematic review of the literature and existing questionnaires the International Consultation on Incontinence short form questionnaire (ICIQ-UI SF) was developed, and has since been translated into many languages for local use. This paper reports the development and validation of the first UI questionnaire in the Arabic language. The development of this questionnaire will facilitate the assessment of UI in both clinical practice and research in the Middle-East. METHODS: Translation and validation of the Arabic version of the ICIQ-UI is described. Standard methods of translation by native Arabic and English speakers (including translation and back translation) are followed. The psychometric properties of the questionnaire, including its validity, reliability and sensitivity to change, are examined. The validation of the questionnaire involved patients attending urology outpatient clinics in two Middle-Eastern countries. RESULTS: The Arabic ICIQ-UI SF was found to be valid, reliable and responsive, indicating that the psychometric properties of the questionnaire have remained constant throughout the adaptation process. Furthermore, the findings of the psychometric testing confirm those found for the UK-English ICIQ-UI SF. CONCLUSIONS: The development of this questionnaire will allow the study of Arabic speaking groups with UI in many countries around the world. This may act as an example to initiate the translation and validation of other patient reported outcomes into the Arabic language, thereby enabling more multinational and cross-cultural research into diseases in given areas.

Humans↗

Arabic pain words.

The initial stages in the development of an Arabic pain inventory are described. 279 Kuwaiti adults were asked to nominate as many words as they could think of to describe pain. A dictionary translation of the McGill Pain Questionnaire (MPQ) was prepared, and subjects judged which of these represent acceptable pain descriptions in Arabic. From these sources, a list of Arabic pain adjectives was compiled. 67 university undergraduates classified each word as sensory, evaluative or affective, and rated the pain intensity connoted. Over 100 Arabic pain words were identified. Ratings revealed that, just as in English, pain is a multidimensional concept. The pain intensity rank ordering of many groupings in the MPQ was preserved when the Arabic translations were rated, even though the Arabic adjectives were not presented in the format of the MPQ. Theoretical and practical problems encountered in producing a fully equivalent pain inventory in another language are discussed.

Adolescent↗

[Translation and construct validity of the Lequesne index for Arab speaking North African patients with osteoarthritis of the knee].

OBJECTIVE: To translate in Arabic and validate the Lequesne index for use in Tunisian. BACKGROUND: No instrument wording in Arabic language and validated in an Arab population to measure lower limb functional disability caused by OA. DESIGN: Arab translation was obtained using the "forward translation/backward translation" method. Adaptations were made after a pilot study. Patients with symptomatic knee osteoarthritis fulfilling the revised criteria of the American College of Rheumatology were included. Impairment outcome measures (VAS pain; knee mobility; Kellgren's radiological score); disability (the maximum distance walked; WOMAC index) and Beck depression scale were recorded. Inter rater reliability was assessed using the intra-class correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated using the Spearman rank correlation coefficient (convergent and divergent validities) and a factor analysis was performed. Internal consistency of each factor was assessed by Crohnbach alpha coefficient. RESULTS: One hundred and three patients were included. All questions were acceptable and retained. Inter rater reliability was excellent with ICC = 0.91. The Bland and Altman method showed distribution of differences homogenous and no systematic trend. Expected divergent validity and convergent validity were observed, suggested good construct validity. Two main factors were extracted by factor analysis of the Lequesne, and explained more than 55% of the cumulative variance, the first factor represents disability and the second represents pain and stiffness. Crohnbach alpha coefficient was, respectively, 0.68 for factor 1 and 0.54 for factor 2. In conclusion, we translated and adapted the Lequesne index into Arabic to suit Tunisian people. Translated questionnaire is reliable and valid. Although the scale was validated in a Tunisian population, we expect that it can suit other Arab populations especially North Africans. Further studies are needed to confirm such hypothesis.

Adult↗

Present situation of echinococcosis in the Middle East and Arabic North Africa.

Echinococcosis is one of the major zoonotic parasitic diseases in the Middle East and Arabic North Africa from Morocco to Egypt. Both cystic and alveolar echinococcosis has been reported from these areas. However, cystic echinococcosis is more prevalent and has been reported from all countries in the Middle East and Arabic North Africa. Alveolar echinococcosis is less prevalent and has been reported only from Iran, Turkey, Iraq and Tunisia. Present situation of echinococcosis in dogs and other definitive hosts, animal intermediate hosts and humans in the Middle East and Arabic North Africa has been reviewed. Echinococcus granulosus is highly prevalent in Iran, Turkey, Iraq, Morocco, Tunisia, and Libya. In the Levant countries, the cystic echinococcosis is also highly endemic. In Oman, it is endemic with low prevalence and a very low level in Cyprus. Various surveys have indicated that hydatid cysts are commonly found in sheep, cattle, goats and camels throughout the Middle East and Arabic North Africa. Sheep are the most infected animals of these regions. Most of studies on human have been focused on surgical reports although several population studies have been performed using serological and imaging techniques. Human cystic echinococcosis (CE) is prevalent in the Middle East and Arabic North Africa. It is hyper endemic in Iran, Turkey, Iraq, Jordan, Morocco, Libya, Tunisia, and Algeria, and endemic in Egypt. Studies on the strain specificities of E. granulosus in the Middle East revealed sheep strain (G1) present in sheep, goats, cattle, camels and humans, and the camel strain (G6) in camels, sheep, cattle as well as humans. Dog/sheep strain seems to be more prevalent in the foregoing regions in documented reports from Iran and Jordan. However, a strain of E. granulosus, which resembles the horse strain (G4) strain, has been reported from Jordan. Strain specifications of E. granulosus in Arabic North Africa showed that sheep/dog strain (G1) have been reported from Tunisia and Libya both from humans and animals. However, in Egypt the human cases reported are of camel/dog strain.

Africa, Northern↗

Foreigners in a strange land: self-construal and ethnic identity in male Arabic immigrants.

Many authors have emphasized the importance of cultural sensitivity in delivering mental health services to immigrants. Self-construal and ethnic identity are important components of the acculturative process, which may be useful in the diagnosis, assessment, and treatment of immigrant clients. This study investigated the self-construal and ethnic identity of male Arabic immigrants in the United States. Based on pilot interview data and existing measures, a Male Arabic Ethnic Identity Measure (MAEIM) was developed using a sample of 115 male Arabic immigrants. Satisfactory reliability is reported for the overall MAEIM as well as its four factor analytically derived scales, including Religious-Family Values, Sense of Belonging/Ethnic Pride, Friendship, and Ethnic Arabic Practices. Arabs reporting a strong Arabic ethnic identity had a more salient interdependent sense of self than those reporting a weaker ethnic identity. Independent self-construal was not significantly correlated with any of the individual MAEIM scales or the total MAEIM scale. The implications of these findings for research and clinical practice are discussed.

Journal Article↗

The writing of arabic numerals, kanji, and kana in brain-damaged patients.

This study investigated the neural mechanisms involved in the writing of Arabic numerals, kanji, and kana. Tasks involving writing numerals in Arabic, kanji, and, kana were administered to four patients with Gerstmann's syndrome and to five Wernicke aphasics. The results indicated that the ability to write Arabic numerals was well preserved in the Wernicke aphasics despite their serious phonological disturbances. The patients with Gerstmann's syndrome, who have a deficit with the concept of number, could write kanji numerals better than Arabic and kana numerals. Unlike Arabic numerals (ideogram) and kana (syllabogram), kanji (morphogram) have both semantic and phonetic values. The results suggested that Arabic numerals may be somesthetic and linked directly to the concept of number bypassing phonological analysis.

Aged↗

Recurrent aphthous ulcerations in a mixed Arab community.

Twenty thousand Arabs of various nationalities living in Kuwait have been investigated over the past 5 years; 5,470 (27%) manifested recurrent aphthous ulcerations (RAU). Non-Kuwaiti Arabs were affected more the Kuwaitis and the prevalence of the disease was respectively 35% and 18%. Among Kuwaitis, only 5% of the Bedouins manifested the diseases whereas 22% of urbanized Arabs were affected. The ratio of the affected females to males in this study was 6:5. The clinical course of RAU in Arabs was similar to that reported in other populations. Various environmental factors such as stressful conditions, social tradition and obligations, and the allergenic Arabic food seemed to affect the prevalence of RAU in different Arab communities.

Female↗