Respiratory health and the Syrian conflict: a scoping literature review.

Conflict adversely affects respiratory health in both direct and indirect ways among populations whose health is already compromised through the compounding effects of conflict. Our aim is to review academic and grey literature relevant to respiratory health in the Syrian conflict (now more than a decade in duration) to explore its impacts on populations across Syria. We performed a scoping literature review of academic and grey literature on respiratory health in Syria between March 2011 (taken as the start of the conflict for practicality) and December 2023. Of 11,472 papers screened, 34 met the inclusion criteria, of which 29 were peer reviewed. Key themes identified included the impact of conflict on asthma diagnosis and management; the burden of respiratory tract infections (RTIs) and COVID-19; the impact of chemical weapon use and the impact of destruction and interruptions to the health system(s) across Syria on respiratory health. This review highlights the need for more in-depth exploration of the impact of conflict on respiratory health in Syria with focus on social determinants, for example, shelter, public health interventions, smoking cessation, and supporting early diagnosis and treatment of respiratory conditions to counter the effects that conflict has had on respiratory health.

Associations between spontaneous preterm birth and maternal-newborn ABO blood phenotype pairs.

OBJECTIVE: To study whether spontaneous preterm birth (SPB) is associated with maternal-newborn ABO blood phenotype pairs. METHODS: We conducted a retrospective case-control study in the Department of Pediatrics, King Abdulaziz Hospital, Al-Ahsa, Kingdom of Saudi Arabia. A total of 631 live singleton SPBs (less than 37 weeks) between August 2005 and May 2011 formed the case group. A total of 2,204 live singleton term births (greater than or equal to 37 weeks) between May 2008 and April 2009 formed the control group. We extracted data on the mothers and their newborns from our neonatal electronic database and delivery room log book. We extracted ABO blood phenotypes using Cerner's Lab Information Software. We used a Chi square test to study the association between SPB and maternal-newborn ABO pairs. We used a combination of maternal-newborn A-A, B-B, AB-AB, and O-O pairs as the reference group. We used a binary logistic regression analysis to adjust for 6 established risk factors for SPB. RESULTS: Spontaneous preterm birth was associated with only maternal-newborn pairs B-A (odds ratio: 2.67, 95% confidence interval: 1.35-5.24, p=0.003) and AB-B (odds ratio: 1.97, 95% confidence interval: 1.04-3.74, p=0.04). Both associations remained significant in the regression analysis. CONCLUSION: Spontaneous preterm birth is associated with maternal-newborn B-A and AB-B pairs. This finding requires further confirmatory and exploratory study as it could reduce SPBs.

Curative effects of hydrogen sulfide against acetaminophen-induced hepatotoxicity in mice.

AIMS: Hydrogen sulfide (H(2)S), an endogenous gaseous mediator, plays an important role in regulation of many physiological and pathological processes. On the other hand, acetaminophen overdose is a major cause of drug-induced liver failure. The aim of this study therefore is to evaluate the possible curative effects of H(2)S against acetaminophen-induced hepatotoxicity. MAIN METHODS: Male Swiss mice were treated with sodium hydrogen sulfide, a H(2)S donor, 30 min after acetaminophen administration. N-acetylcysteine, a therapeutic antidote, was used as a reference drug. KEY FINDINGS: H(2)S treatment resulted in hepatocurative effects as evident by a significant decrease in serum alanine aminotransferase and hepatic malondialdehyde and nitric oxide levels, with a concurrent increase in hepatic glutathione content compared to acetaminophen-treated group. H(2)S did not alter catalase activity. Additionally, immunohistochemical analysis demonstrated that H(2)S treatment markedly reduced tumor necrosis factor-α expression, while expression of cyclooxygenase-2 was markedly enhanced with nuclear localization into hepatocytes. The curative effects of H(2)S were confirmed by liver histopathological examination and were maintained in the presence of glibenclamide, an antagonist of ATP-sensitive potassium (K(ATP)) channels. SIGNIFICANCE: H(2)S treatment markedly alleviates acetaminophen hepatotoxicity in mice possibly, in part, through anti-oxidative and anti-inflammatory effects but not likely to be coupled with activation of K(ATP) channels. The hepatocurative effects of H(2)S are comparable to N-acetylcysteine. Hence, H(2)S has a potential therapeutic value for treatment of acetaminophen hepatotoxicity.