First report on simplified diagnostic criteria for pre-hypertension and hypertension in a national sample of adolescents from the Middle East and North Africa: the CASPIAN-III study / Primeiro relatório sobre critérios de diagnóstico simplificado para pré-hipertensão e hipertensão em uma amostra nacional de adolescentes do Oriente Médio e da África do Norte: o estudo CASPIAN-III

OBJECTIVE: This study aimed to simplify the diagnostic criteria of pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group, and to determine the accuracy of these simple indexes in a nationally-representative sample of Iranian children and adolescents. METHOD: The diagnostic accuracy of the indexes of systolic blood pressure-to-height ratio (SBPHR) and diastolic BPHR (DBPHR) to define pre-HTN and HTN was determined by the area under the curve of the receiver operator characteristic curves. RESULTS: The study population consisted of 5,738 Iranian students (2,875 females) with mean (SD) age of 14.7 (2.4) years. The prevalences of pre-HTN and HTN were 6.9% and 5.6%. The optimal thresholds for defining pre-HTN were 0.73 in males and 0.71 in females for SBPHR, and 0.47 in males and 0.45 in females for DBPHR, respectively. The corresponding figures for HTNwere 0.73, 0.71, 0.48, and 0.46, respectively. In both genders, the accuracies of SBPHR and DBPHR in diagnosing pre-HTN and HTN were approximately 80%. CONCLUSIONS: BPHR is a valid, simple, inexpensive, and accurate tool to diagnose pre-HTN and HTN in adolescents. The optimal thresholds of SBPHR and DBPHR were consistent with the corresponding figures in other populations of children and adolescents with different racial and ethnic backgrounds. Thus, it is suggested that the use of these indexes can be generalized in programs aiming to screen elevated blood pressure in the pediatric age group. .

OBJETIVO: Este estudo visa simplificar os critérios de diagnóstico da pré-hipertensão (pré-HTA) e hipertensão (HTA) na faixa etária pediátrica e determinar a precisão desses índices simple sem uma amostra nacionalmente representativa de crianças e adolescentes iranianos. MÉTODO: A precisão diagnóstica dos índices de relação pressão arterial sistólica/altura (RPASA) e RPAA diastólica (RPADA) para definir a pré-HTA e HTA foi determinada pela área sob as curvas de características de operação do receptor. RESULTADOS: A população estudada contou com 5738 alunos iranianos (2875 meninas) com idade média (DP) de 14,7 (2,4) anos. A prevalência de pré-HTA e HTA foi 6,9% e 5,6%. Os limites ideais para a definição de pré-HTA foram 0,73 em meninos e 0,71 em meninas com relação à RPASA e 0,47 em meninos e 0,45 em meninas com relação à RPADA, respectivamente. Os valores correspondentes com relação à HTA foram 0,73, 0,71, 0,48 e 0,46, respectivamente. Em ambos os gêneros, a precisão de RPASA e RPADA no diagnóstico de pré-HTA e HTA foi de aproximadamente 80%. CONCLUSÕES: A RPAA é uma ferramenta válida, simples, barata e precisa no diagnóstico da pré-HTA e HTA em adolescentes. Os limites ideais de RPASA e RPADA foram compatíveis comos números correspondentes em outra população de crianças e adolescentes com diferentes históricos raciais e étnicos, assim, sugerimos que a utilização desses índices possa ser generalizada em programas de triagem com relação à PA elevada na faixa etária pediátrica. .

Sickle cell disease in Middle East Arab countries.

The sickle cell (HbS) gene occurs at a variable frequency in the Middle Eastern Arab countries, with characteristic distribution patterns and representing an overall picture of blood genetic disorders in the region. The origin of the gene has been debated, but studies using β-globin gene haplotypes have ascertained that there were multiple origins for HbS. In some regions the HbS gene is common and exhibits polymorphism, while the reverse is true in others. A common causative factor for the high prevalence and maintenance of HbS and thalassaemia genes is malaria endemicity. The HbS gene also co-exists with other haemoglobin variants and thalassaemia genes and the resulting clinical state is referred to as sickle cell disease (SCD). In the Middle Eastern Arab countries, the clinical picture of SCD expresses two distinct forms, the benign and the severe forms, which are related to two distinct β-globin gene haplotypes. These are referred to as the Saudi-Indian and the Benin haplotypes, respectively. In a majority of the Middle Eastern Arab countries the HbS is linked to the Saudi-Indian haplotype, while in others it is linked to the Benin haplotype. This review outlines the frequency, distribution, clinical feature, management and prevention as well as gene interactions of the HbS genes with other haemoglobin disorders in the Middle Eastern Arab countries.

Incidence of stomach cancer in oman and the other gulf cooperation council countries

Stomach cancer is the most common cancer among males in Oman and the second most frequent among females from 1997 to 2007. Reports have suggested the rate is higher in Oman than in the other GCC countries. This study aims to describe the epidemiology of stomach cancer in Oman and to explore the apparent differences in the incidence of stomach cancer between Oman and the other Gulf Cooperation Council [GCC] countries. Data were obtained from the Omani National Cancer Registry [1997-2007] and from Gulf Centre for Cancer Registration reports [1998-2004]. The annual average age-adjusted incidence rates for stomach cancer in Oman were 10.1 per 100,000 for males and 5.6 per 100,000 for females between 1997 and 2007. The age-adjusted incidence varied by region within Oman, and the incidence rate was higher in Oman than in most other GCC countries between 1998 and 2004. Further investigation of the completeness and accuracy of cancer registration is essential for exploration of variations in stomach cancer rates in the GCC countries

Prevalence of Toxocara canis in Dogs, North West Bank of Palestine

This study was performed to investigate the prevalence of Toxocara canis in local districts in North West Bank of Palestine. Fecal samples from 132 dogs were collected in Nablus, Tulkarm, and Jenin cities from September 2008 to April 2009 and examined for T. canis eggs with the floating technique. The overall infection rate of toxocariasis in dogs was 36.4%. The dogs less than 6 months old showed higher infection rates than those older than 12 months (P=0.04). Vigorous interventions are necessary, such as routine coprological examinations of dogs and prescription of anthelmintics to infected dogs.

impact of non-compliance with the therapeutic regimen on the development of stroke among hypertensive men and women in Gaza, Palestine

Hypertension and stroke are 2 major public health problems worldwide. Several biological and non-biological risk factors for stroke have been identified in the past. Little is known regarding risk factors for stroke among the Arabic population in Gaza. To identify potential risk factors we investigated compliance with the therapeutic regimen and life style factors which may increase the risk for stroke. To research this study question, a pair matched case control study was conducted in Gaza Strip [Shefa Hospital, Nasser Hospital, Khan Younis Hospital, and related primary health care clinics] in 2001 [from January through to December] among 112 patients, who had been hospitalized for acute stroke and history of hypertension, and 224 controls with history of hypertension from primary health care clinics. Conditional logistic regression models show significant associations between stroke and medication not taking as prescribed [odds ratio [OR]=6.07; 95% confidence interval [CI]=1.53, 24.07], using excessive salt at meals [OR=4.51; 95% CI=2.05, 9.90], eating diet high in fat [OR=4.67; 95% CI=2.09, 10.40], and high levels of stress [OR=2.77; 95% CI=1.43, 5.38]. No significant association between smoking and the development of stroke [OR=2.12; 95 CI 0.82, 5.51] was found. Regular physical exercise was a protective factor [OR=0.26; 95% CI=0.12, 0.57]. Our results on risk factors for stroke confirm several other studies. In future programs on health promotion among hypertensive men and women in Gaza these modifiable risk factors could be addressed by health education strategies

Factors involved in the re-emergence of malaria in borderline of Iran, Armenia, Azerbaijan and Turkey.

The borderline of Iran with Azerbaijan, Armenia and Turkey had been considered a malaria free region. However, in 1991, after the independence of the southern countries of the former Soviet Union, a new threat of malaria importation emerged from those countries into Iran, which was affected by serious epidemics of Plasmodium vivax malaria. Various factors can affect malaria resurgence in this region, such as socioeconomic conditions, especially the displacement of massive populations from war-stricken zones in the Republic of Azerbaijan. Accordingly, in some parts of West-Azerbaijan, East-Azerbaijan, Ardebile and Gilan provinces of Iran, several malaria foci were observed. Construction of dams, people traveling from neighboring countries to Iran, urbanization, irrigation projects, lack of malaria vector control, shortage of drug supplies are also major factors in malaria outbreaks in the region. An investigation was carried out on the bionomics of the main malaria vectors in the region. The result showed that Anopheles sacharovi plays an important role in malaria transmission and An. maculipennis and An. superpictus can be secondary vectors. Larvae were found in slow flowing water and channels with water plants. They were more abundant in June. The parity rate of blood-fed females was high in May. An. sacharovi is active from May to October with two peaks of activity, which occur in August and October. The population of this species is higher in animal shelters with a zoophicity of 95%. About 90% of bites took place in the second half of the night. A CDC light trap can also catch this species. Susceptibility testing using the WHO-recommended diagnostic doses of insecticides, revealed that this species is resistant to DDT and dieldrin, but susceptible to malathion, fenitrothion, propoxur, bendiocarb, lambdacyhalothrin, permethrin, cyfluthrin, etofenprox and deltamethrin.