Verification of 2021 IDF-DAR risk assessment tool for fasting Ramadan in patients with diabetes attending primary health care in The Kingdom of Bahrain: The DAR-BAH study.

BACKGROUND: There is a high prevalence of diabetes mellitus among Muslim adult patients. Those Muslims are required to fast the holy month of Ramadan. However, the Islam religion exempted some people with medical issues. It was not clear if all the patients with diabetes were considered medically unfit to fast Ramadan. Therefore, IDF-DAR group created a new risk calculator to categorize the patients with diabetes to advise with or against fasting accordingly. OBJECTIVE: This study is validating the IDF-DAR tool in assessing the accuracy of IDF-DAR risk calculator tool on adult patients with diabetes visiting primary health care in the Kingdom of Bahrain. The study will facilitate the health care professionals' decision to exempt the patients from fasting. METHODS: It is a prospective, randomized study for Ramadan 1444/2023 to assess the new IDF-DAR risk score tool that predicts the complications and the negative outcome of fasting during Ramadan. It included pre- and post-Ramadan questionnaires. 757 patients were selected randomly from the patients list of the central diabetes clinics in primary health care for pre-Ramadan risk assessment scoring. Post-Ramadan a phone a questionnaire was done to evaluate the ability of fasting and the occurrence of adverse events. RESULTS: Out of the 757 participants, 611 were included in the study. The mean age of the studied population was 59.8 years and 52.8 % of them were female. 630 (95.3 %) had type 2 diabetes. According to the new IDF-DAR risk calculator, 184 (27.8 %) were categorized as low risk (≤3 score), 252 (38.1 %) as moderate risk (3-6 score), and 225 (34 %) as high risk (>6 score). The percentage of patients completed their 30 days fasting successfully without reporting adverse events in the low, moderate, and high-risk groups were 92.4 %, 89.3 %, 74.7 % respectively. There was significant increased risk in breaking the fast between the low-risk group and high-risk group with a p-value of <0.001. Similarly, there was significant increased risk in breaking the fast between the moderate-risk group and high-risk group with p-value of <0.001. The main reason of breaking the fast was hypoglycemic attacks. The leading factors that play a significant role in increasing the risk of adverse events during fasting Ramadan were type 1 diabetes mellitus, the presence of previous hypoglycemia attacks, the presence of renal impairment, and negative previous Ramadan experience. CONCLUSION: The new IDF-DAR risk calculator is a good tool to predict both the ability to fast Ramadan and the probability of experiencing adverse events (mainly hypoglycemia) in people with diabetes mellitus in Kingdom of Bahrain.

Long-term statistical assessment of meteorological indicators and COVID-19 outbreak in hot and arid climate, Bahrain.

The COVID-19 pandemic has significantly impacted the global lifestyle, and the spreading of the virus is unprecedented. This study is aimed at assessing the association between the meteorological indicators such as air temperature (°C), relative humidity (%), wind speed (w/s), solar radiation, and PM2.5 with the COVID-19 infected cases in the hot, arid climate of Bahrain. Kendall and Spearman rank correlation coefficients and quantile on quantile regression were used as main econometric analysis to determine the degree of the relationship between related variables. The dataset analysis was performed from 05 April 2020, to 10 January 2021. The empirical findings indicate that the air temperature, humidity, solar radiation, wind speed indicators, and PM2.5 have a significant association with the COVID-19 newly infected cases. The current study findings allow us to suggest that Bahrain's relatively successful response to neighboring GULF economies can be attributed to the successful environmental reforms and significant upgrades to the health care facilities. We further report that a long-term empirical analysis between meteorological factors and respiratory illness threats will provide useful policy measures against future outbreaks.

Skin cancer-related knowledge, attitudes, beliefs, and practices among the population in Gulf Cooperation Council countries: a systematic search and literature review.

Skin cancers are the most common malignancies diagnosed worldwide. In Gulf Cooperation Council (GCC) countries, skin cancer remains a significant health burden. Multiple studies have attempted to elucidate patient knowledge and attitudes regarding skin cancer risks and behavioral interventions to reduce risks. A systematic literature search of relevant articles was conducted in PubMed, ScienceDirect, and the Saudi Digital Library databases. A narrative analysis of relevant study results was conducted. A total of 12 studies were reviewed across GCC. These studies revealed common themes among GCC populations. Many study participants were aware that excess sun exposure represents a threat to health and increases cancer risk. Several studies reported sun exposure, with a mean of 19.13 h per week. More studies reported patients engaging in lower or no sunscreen use rather than regular sunscreen use. There are discrepancies in the understanding of sun exposure risk and risk mitigation practices among the study populations. Skin cancer poses a significant burden to patients in GCC countries and improved patient education will enhance population health.

Human development index, maternal mortality rate and under 5 years mortality rate in West and South Asian countries, 1980-2010: an ecological study.

BACKGROUND: Human Development Index (HDI), maternal mortality rate (MMR) and children aged under 5 years mortality rate (U5MR) are fundamental issues, especially in low- and middle-income countries. AIMS: The aim of this study was to evaluate the changes in HDI, MMR and U5MR from 1980 to 2010 in certain West Asian countries as well as the relationship between these indexes. METHODS: In this ecological study, HDI, MMR and U5MR information from studied countries during 1980 to 2010 was extracted from the gap minder site and then analysed using descriptive and analytical methods, including Spearman correlation. RESULTS: The lowest and highest rates of HDI and MMR in 2010 were seen in the United Arab Emirates and Pakistan (HDI: 0.49, 0.81; MMR: 7.14, 335.45 respectively). HDI is rising in all countries studied, with the highest increase in the Islamic Republic of Iran (0.21). MMR and U5MR saw a decline over the years, with the greatest decrease seen in India, and the lowest and highest child mortality rate in 2010 found in Bahrain and Pakistan (8.3, 91.8 respectively). However, there was a negative relationship between HDI and MMR (r = -0.7, P < 0.001). CONCLUSIONS: HDI increased during 1980-2010. The highest rate of HDI decrease was observed in the Islamic Republic of Iran, and the greatest reduction of MMR was seen in India. Also, the highest decrease in U5MR was related to India as well, while MMR and U5MR rate decreased. Hence, improving HDI might have a definite impact on decreasing MMR and U5MR, especially in low- and middle-income countries.

Growth assessment and risk factors of malnutrition in children with cystic fibrosis.

OBJECTIVES: To evaluate the nutritional status, to screen for the presence of malnutrition, and to study the possible risk factors associated with malnutrition in patients with cystic fibrosis (CF). METHODS: A retrospective cross-sectional review of medical records of all diagnosed CF patients in the Pediatric Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain, between January 1984 and May 2015 was conducted. Demographic and anthropometric data were collected from records of last visit to CF clinic. Nutritional status and risk factors of malnutrition were assessed. RESULTS: All records of 109 CF patients were reviewed. Forty-seven pediatric patients were included in the study. All included patients were on pancreatic enzyme replacement and 42 (89%) received high-calorie supplementation. Growth failure was noted in 34 (72%) patients, 19 (56%) were wasted and stunted, 8 (23.5%) were wasted only, and 7 (20.5%) were stunted. Low birth weight (p=0.032), and the presence of gastroesophageal reflux disease (GERD) (p=0.039) were the significant risk factors for malnutrition. CONCLUSIONS: Most CF patients in Bahrain (72%) are malnourished. Low birth weight and the presence of GERD are risk factors.

Role of shame in the stigmatization of people with human immunodeficiency virus: a survey of female college students in 3 Arab countries.

AIDS stigma is a challenge to controlling HIV/AIDS epidemic especially in more conservative cultures. This study explored the impact of knowledge about HIV and AIDS, and the impact of shame, on the stigmatization of people living with HIV/AIDS in the Arab world. Survey data were collected from 277 female college students in 3 Arab countries: Kuwait, Bahrain and Jordan. Only in Bahrain was knowledge about HIV and AIDS inversely related to negative attitudes toward people with HIV/AIDS. AIDS-related shame, however, was a strong predictor of AIDS stigma in all 3 countries. HIV education is needed for young people in Arab countries, especially women, both for their own health and to reduce the problem of AIDS stigma.

Tobacco education in medical schools: survey among primary care physicians in Bahrain.

This cross-sectional study assessed the extent of tobacco education and intervention skills training among primary care physicians in Bahrain. Out of 217 family physicians in the country, 120 (55%) answered a self-administered questionnaire. A total of 24% were current smokers and 10% were ex-smokers. Inadequate education at medical school about tobacco use and interventions was reported by the majority of physicians. The subject of smoking-related diseases, psychology of tobacco use and management of tobacco dependence were inadequately covered in medical schools. Training in smoking cessation was particularly neglected, with only 4% of physicians receiving training about tobacco cessation interventions.

Psychiatric and socioenvironmental characteristics of Bahraini suicide cases.

The characteristics of suicide victims have not been studied systematically in Arab countries. A questionnaire-guided interview of families of 29 Bahraini suicide cases from 1996 to 2005 was conducted in their homes by a social worker. Medical and psychiatric files were examined to complete the data. More suicide victims were male, young, single or divorced, unemployed and with a low education level compared with the general population. The majority of victims had chronic mental disorders, mainly schizophrenia, depression and substance abuse. The most notable environmental risks were reported to be family problems, family history of suicidal behaviour, and financial and relationship problems. The sociodemographic and clinical risk profile in Bahrain differs from other developed and developing countries.

Anthropometric characteristics of Pakistani school children living in Bahrain.

BACKGROUND: This survey was designed to study the gender difference in physical growth of 1113 Pakistani children (646 male and 467 female) living in Bahrain and to compare growth with their Bahraini and Pakistani counterparts. METHODS: Measurements of height, weight, mid-arm circumference, biceps, triceps, subscapular and suprailiac skinfold thickness were carried out using the standard methods, and the median values for height and weight were plotted against the National Center for Health Statistics (NCHS) standard charts. RESULTS: The median weight of the boys was below the 25th percentile rising slightly above the 25th percentile at 12 years. The median height was also below the 25th percentile touching the 25th percentile only between 10-12 and 17 years. In girls, the median weight touched the 50th percentile at 15 years, followed by a fall to the 5th percentile between 16 and 17 years of age while the median height touched the 5th percentile at 17 years of age. The median body mass index (BMI) values were above the 50th percentile between 13 and 15 years in boys, and below the 50th percentile at all ages in girls. The median triceps skinfold thickness in boys was above the 50th percentile between 10-15 and 17 years in boys and in girls it was mostly below the 50th percentile rising above 50th percentile at 14, 15 and 17 years of age. CONCLUSION: The height and weight of the study group was similar to that of children residing in Pakistan for both the genders, but lower than their Bahraini counterparts for most age groups compared. Furthermore, Pakistani boys residing in Bahrain were taller after 14 years of age and heavier after 16 years of age compared to their female counterparts.

Gender-based treatment outcomes in diabetic hypertension.

BACKGROUND: In developing countries, gender-based treatment disparities in cardiovascular preventive therapy have received little attention. AIMS: To evaluate the gender-based differences in cardiovascular disease risk profile, drug prescribing pattern, and blood pressure (BP) and glycemic control rates in diabetic hypertensives treated at primary care setting in Bahrain. SETTINGS AND DESIGN: A retrospective study at primary care setting. MATERIALS AND METHODS: An audit of the medical records of 392 diabetic hypertensives (127 men, 265 women). RESULTS: BP and glycemic targets were achieved in < 10% and < 13% of diabetic hypertensives, respectively. Angiotensin converting enzyme inhibitors monotherapy was more often prescribed in males. Apart from this, no significant differences in prescribing pattern were observed between male and female diabetic hypertensives treated with either antihypertensive mono or multidrug therapies. With the exception of insulin which was more often prescribed to females, a similar prescribing pattern and rank order of antidiabetics, either as monotherapy or combinations, was observed in both genders. The majority of diabetic hypertensives were at high cardiovascular risk. The body mass index and total cholesterol level were greater in females. Prescribing lipid-lowering drugs and aspirin were suboptimal; aspirin was more often prescribed to males. There was no gender-based difference with regard to the use of lipid-lowering drugs. CONCLUSIONS: BP and glycemic controls were suboptimal in both male and female diabetic hypertensives treated by primary care physicians. Cardiovascular disease preventive strategies have received little attention regardless of gender or other risk factors. Gender-based treatment inequities also need to be addressed.

Tobacco control in Bahrain: an overview.

Tobacco control interventions in Bahrain started in the late 1970s and tobacco legislation was introduced in 1994. The tobacco control approach incorporated the international recommended strategies according to the Gulf Cooperation Council and World Health Organization. Recently the tobacco control plan and tobacco legislation were reviewed. A new national comprehensive plan is put forward for implementation by the Ministry of Health. This report examines the Bahrain tobacco control approach, focusing on tobacco legislation, youth smoking, waterpipe smoking, tobacco surveillance and the smoking cessation plan. A number of recommendations for further improvement are discussed.

Student screening for inherited blood disorders in Bahrain.

In Bahrain and neighbouring countries inherited disorders of haemoglobin, i.e. sickle-cell disease, thalassaemias and glucose-6-phosphate dehydrogenase (G6PD) deficiency, are common. As part of the National Student Screening Project to determine the prevalence of genetic blood disorders and raise awareness among young Bahrainis, we screened 11th-grade students from 38 schools (5685 students), organized lectures and distributed information about these disorders. Haemoglobin electrophoresis, high performance liquid chromatography, blood grouping and G6PD deficiency testing were performed. Prevalences were: 1.2% sickle-cell disease; 13.8% sickle-cell trait; 0.09% beta-thalassaemia; 2.9% beta-thalassaemia trait; 23.2% G6PD deficiency; 1.9% G6PD deficiency carrier. Health education, carrier screening and premarital counselling remain the best ways to reduce disease incidence with potentially significant financial savings and social and health benefits.

Oesophageal cancer in Bahrain.

ABSTRACT Data from all 148 cases of oesophageal cancer in Bahrain during 1952-99 were analysed according to patient sex and age and site and histological pattern of tumour, and compared with other Gulf countries. In Bahrain, oesophageal cancer accounted for 2.6% of malignant neoplasms. The female:male ratio was 1.8:1, and the majority of patients were > or =51 years and < or =70 years of age. The lower and upper third of the oesophagus were the most and least frequently involved sites, respectively. Squamous carcinoma (males) and adenocarcinoma (females) were the main histological types. There is varying consistency between these data and those of other Gulf countries having similar anthropological and demographic profiles. A prospective study may help to better understand the aetiology of the disease and inform preventive policies.

Lifestyle patterns in smokers and non-smokers in the state of Bahrain.

The purpose of the study was to compare Bahraini adult male and female smokers with former smokers and non-smokers with respect to several aspects of lifestyle. A simplified general method for cluster-sample survey was used to select 516 subjects aged 30-79 years. Study subjects were interviewed using a structured pre-tested questionnaire. The prevalence of smoking was 32.1 and 20.7% among men and women, respectively. A statistically significant association (p < 0.001) was observed with respect to smoking status and educational level in both sexes. Smoking was associated with less exercise and more television watching. The findings suggest that smokers should be counseled about their unhealthy lifestyle habits in addition to quitting smoking.

Bahraini women's health: a background paper.

This study assessed the trends in the health status of Bahraini women from the early 1980s to the mid 1990s through review of census data and health data. Sociodemographic characteristics, reproductive health, mortality, morbidity and lifestyle patterns were studied. The implications of the data and measures needed to be taken to further improve the health and health care services of women are discussed.

Obesity among secondary school students in Bahrain.

The aim of this study is to estimate the prevalence of obesity and factors associated with it in Bahraini secondary school students. A cross-sectional study involving a sample of 825 students (417 boys and 408 girls) aged 15 to 21 years was obtained from secondary schools. Obesity was determined using body mass index (BMI = Wt/Ht2). The findings revealed that 15.6% of boys and 17.4% of girls were either overweight or obese (BMI > or = 25). Family size, parents education, and family history of obesity were significantly associated with obesity among boys, while family history was the only socio-economic factors statistically associated with obesity among girls. Meal patterns such as eating between meals, number of meals per day, and method of eating were not associated with obesity in students. Boys who ate alone were 3 times more likely to be obese than those who ate with family members (odd ratio = 3.4). Measures to prevent and control obesity among children are suggested.