Capacity of Palestinian primary health care system to prevent and control of non-communicable diseases in Gaza Strip, Palestine: A capacity assessment analysis based on adapted WHO-PEN tool.

The prevalence of non-communicable diseases (NCDs) are increasing in low-income countries including Palestine. This study was conducted to assess the capacity of Palestinian primary health care system to prevent and control of NCDs. This cross-sectional study in which, the World Health Organization package of essential NCDs interventions (WHO-PEN) tool, was used to assess the capacity of primary health care centers (PHCs) to prevent and control of NCDs. All governmental PHCs (n = 52) in Gaza Strip, Palestine were included in the final analysis. The centers readiness score was calculated as the average of domains indices. Then, the indices were compared to an agreed cutoff at 70%. Statistical analysis was performed using SPSS version 22. Out of 52 PHCs, only 21 (40.4%) were considered ready to prevent and control of NCDs; the highest readiness score was 79.4% and the lowest score was 29.2%. Furthermore, all governorates were not ready to prevent and control of NCDs (The readiness scores were < 70%), distributed as follow: 68.6%, 68.1%, 67.7%, 62.5% and 56.4%, for Rafah, Gaza, Khan-Yunis, Deir Al Balah and North Gaza, respectively. The governorates were differed significantly in terms of availability of aneroid blood pressure measuring devices, electrocardiography devices, Glibenclamide and Salbutamol tablets, patients counseling for diabetes self-management, patients education for self-administration of insulin (P values <.05 for all). The current study demonstrated critical gaps in the governmental PHCs capacity to prevent and control of NCDs, as most of PHCs failed to reach the minimum threshold of the WHO-PEN standards.

Knowledge, attitudes, and practices toward blood donation in the Gaza Strip, Palestine.

Aims: Both developing and developed countries are facing difficulties in finding regular donors. In areas that are exposed to frequent conflicts and wars, such as the Gaza Strip, there is a need for a continuous blood supply. This study aims to determine the level of knowledge, attitudes, and practices toward blood donation in the Gaza Strip, Palestine. Methods: A cross-sectional study was conducted in 2022, in which 1506 participants were randomly selected from different governorates in the Gaza Strip. A structured and valid questionnaire was employed to assess the level of knowledge, attitudes, and practices toward blood donation. All statistical analyses were performed using SPSS version 28. The chi-square test was used to measure the significance of associations. Results: A total of 1506 individuals living in the Gaza Strip participated. The total mean score of the overall knowledge and positive attitudes toward blood donation was 55.1% and 67.1%, respectively. Furthermore, 1236 (82.1%) of the study participants never donated blood. Of them, 260 (21.0%) demonstrated that they do not have information on when, where, and how to donate; 228 (18.4%) thought that they were not fit to donate; 187 (15.1%) demonstrated that they did not have time to donate; 143 (11.6%) feared health problems, and 132 (10.7%) feared anemia. On the contrary, 99 (36.7%) donated blood when a friend or relative needed blood, and 171 (63.3%) were voluntary donations. Statistically, a significant association was found between knowledge, attitudes, practices, and sociodemographic variables (p < 0.05 for all). Discussion: The study findings indicated poor donation habits despite positive attitudes toward blood donation in the Gaza Strip, Palestine. This research emphasizes the need to recognize and correct the knowledge gap that results in unfavorable behaviors against blood donation.

Assessment of serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension: a case-control study.

Background: This study assessed serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension (PIH). Methods: This case-control study was conducted in 2022, in the three main Obstetrics and Gynecology departments in Gaza Strip, Palestine. One hundred sixty pregnant women, during the third trimester, aged ≥20 years, were selected using a convenient sampling method. Data were obtained using an interview-based questionnaire, food frequency questionnaire, anthropometric measures, and biochemical tests. Statistical analysis was performed using SPSS version 24. Results: The participants' mean age was 30.7 ± 5.6 years. A total of 47 (58.8%) of cases and 6 (7.5%) of controls were insufficiently active; and the mean of blood pressure (mmHg) was 133.3 ± 11.9/85.11 ± 10.0 for cases and 112.8 ± 9.5/68.02 ± 7.2 for controls with significant differences between the two groups (P = <0.005). The mean serum zinc level (µg/dl) was 67.15 ± 16.5 for cases and 68.45 ± 18.0 for controls without significant differences between the two groups (P = 0.636). For newborns, the mean birth weight (g) was 2,904.6 ± 486 for cases, and 3,128.3 ± 501 for controls, and the mean Apgar score was 8.03 ± 0.62 for cases and 8.30 ± 1.17 for controls, with significant differences between the two groups (P = <0.005). Furthermore, 43 (53.8%) of cases have family history of hypertension; 5 (6.2%) were primiparous; 19 (23.8%) have previous caesarian section; 33 (41.2%) have history of preeclampsia; and 62 (77.5%) have edema, with significant differences between the two groups (P = <0.005). Additionally, the total zinc dietary daily intake (mg/day) was 4.15 ± 2.10 for cases and 4.88 ± 3.02 for controls, with significant differences between the two groups (P = 0.041). After adjustment for confounding variables, participants in the case group have higher odds of having low total zinc dietary intake compared to those in the control group [OR = 1.185, 95% CI = (1.016-1.382), P = 0.030]. Conclusion: The current study showed the main risk factors of PIH among pregnant women in the Gaza Strip, Palestine. Furthermore, low maternal dietary zinc intake was associated with a high level of PIH. Moreover, having PIH could increase the risk of low birth weight and low Apgar scores. Therefore, reducing the main risk factors of PIH could reduce the adverse effect on both mother and birth outcomes.

Households' Food Insecurity and Its Association with Demographic and Socioeconomic Factors in Gaza Strip, Palestine: A Cross-Sectional Study.

Background: This sudy aimed to identify the prevalence of household's food insecurity and its association with demographic and socioeconomic factors. Methods: A cross-sectional study was conducted in September 2021 among a representative sample of households in the Gaza strip governorates. A total of 1167 households randomly selected from all five governorates and were included in the study. The Radimer/Cornell food security scale was used to determine the prevalence and levels of household food insecurity. The household's demographic and socioeconomic characteristics were obtained using an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. Results: The overall prevalence of household's food insecurity was 71.5%. The prevalence by governorates was highest in Gaza (30.8%), followed by Khanyounis (23.0%), North-Gaza (18.6%), Middle-Area (15.2%) and Rafah (12.4%). Regarding the food insecurity levels, 333 (28.5%) of the households were food secure, 422 (36.2%) had mild food insecurity, 161 (13.8%) had moderate food insecurity, and 251 (21.5%) had severe food insecurity. Significant associations were found between governorates, monthly income, homeownership, work status with the household's food insecurity, (Crude OR [COR] = 2.02, 95% CI = [1.02-3.98], P value < 0.05), (COR = 2.00, 95% CI = [1.04-2.75], P value < 0.05), (COR = 2.36, 95% CI = [1.39-3.99], P value < 0.05), and (COR = 1.14, 95% CI = [0.66-1.97], P value < 0.05), respectively. Conclusions: Our study demonstrates that food insecurity is highly prevalent in the Gaza strip and is associated with poor living conditions. Therefore, this high prevalence should be seriously discussed and urgently considered.

Association of household food insecurity with dietary intakes and nutrition-related knowledge, attitudes, and practices among parents, aged ≥ 18 years in Gaza Strip, Palestine: A descriptive study.

The purpose of this study was to examine the association between household food insecurity and dietary intake and nutrition-related knowledge, attitudes, and practices (KAP) among parents aged ≥18 years in the Gaza Strip, Palestine. The current cross-sectional study was carried out in 2021 among adults (mothers and fathers) aged ≥18 years. A total of 614 participants were selected from all Gaza Strip governorates using a cluster random sampling method. To assess the nutrition-related KAP, we employed the Food and Agriculture Organization (FAO) of the United Nations questionnaire (Modules 5, 6, 7, and 9). Data regarding household food security status, demographic and socioeconomic characteristics of the study participants, anthropometric measurements, and dietary intakes were obtained using standard questionnaires and methods. Statistical analysis was performed using SPSS version 25. About 71.5% and 28.5% of the study participants were household food-insecured and household food-secured, respectively. Significant associations were found between participants from household food-secured and household food-insecured concerning several socio-demographic variables, anthropometric measures, intakes of energy, protein, carbohydrate, and calcium; nutrition-related knowledge and attitudes toward undernutrition and vitamin A deficiency; nutrition-related KAP of iron deficiency anemia; and nutrition-related attitudes and practices of food safety (P-values < 0.05 for all). In conclusion, the demographic and socioeconomic status, anthropometric measurements, and poor dietary intakes may be associated with high levels of household food insecurity, while having nutrition-related adequate KAP may be associated with low levels of household food insecurity among parents aged ≥18 years.

Do Patients with Major Non-Communicable Diseases Receive Advice on Health Behaviors from Healthcare Professionals in the Gaza Strip, Palestine?

BACKGROUND: NCDs tend to be long-term and are caused by genetic, physiological, environmental, and behavioral factors. Currently, NCDs account for 71% of deaths globally. The current study aimed to explore whether patients with NCDs receive advice on health behaviors from healthcare professionals in the PHCs in the Gaza Strip, Palestine. METHODS: This research applied a cross-sectional survey design in five PHCs from October 2019 to December 2019, with 360 patients selected using a convenience sampling technique. A structured questionnaire on sociodemographic, history and patients' views on receiving advice on health behaviors from health care professionals was developed and collected. Data were analyzed using descriptive analyses and a One-way ANOVA test through SPSS-v22. RESULTS: The patients reported receiving advice as follows: in terms of regular physical activity (54.5% ±13.6), in terms of eating a heart-healthy diet (49.3% ±11.5), in terms of treatment adherence (86.1% ±8.1), and in terms of stop tobacco for smokers' patients (43.9% ±16.8). Statistically significant differences were found between the five Gaza strip governorates in terms of regular physical activity, eating heart-healthy, and treatment adherence (P values <.05 for all). CONCLUSION: Participants claimed that the vast majority of them had received advice from healthcare professionals regarding attending regular follow-up and treatment adherence. In contrast, participants reported receiving advice from health care professionals regarding regular physical activity, eating a healthy diet, and stopping tobacco are suboptimal. There is a need to develop a strategy to ensure that healthcare professionals are committed to providing advice on health behaviors.

Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine.

The present study aimed to determine the households' food insecurity and their association with dietary intakes, nutrition-related knowledge, attitudes and practices (KAP) among under-five children in the Gaza Strip, Palestine. This cross-sectional study was conducted in 2021 among a representative sample of under-five children. A total of 350 children and their proxy were selected from all Gaza strip governorates, using a cluster random sampling method. The Radimer/Cornell food-security scale was used. A 24-h dietary recall was employed for dietary intakes assessment. Nutrition-related KAP for feeding under-five children, anthropometric measurements, and demographic-socioeconomic characteristics were obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. The children from food-insecure households had a high prevalence of moderate underweight (30.4%), stunting (32.8%), wasting (9.6%), and acute undernutrition (30.4%). Between food-insecure and food-secure groups there were significant differences in weight, height/length, mid-upper arm circumference, weight-for-age and mid-upper arm circumference z-scores, underweight, acute undernutrition, intakes of protein, fat, vitamin D, zinc, continued breastfeeding, having nutrition-related adequate knowledge, having nutrition-related positive attitudes, and achieved minimum dietary diversity score (P < 0.05 for all). Additionally, about (56.0%) food-insecure households have inadequate nutrition-related knowledge, (77.6%) have nutrition-related negative attitudes, and (95.2%) did not achieve a minimum dietary diversity score. In conclusion, the children from food-insecure households had a high prevalence of moderate underweight, stunting, wasting, and acute undernutrition. Moreover, low economic status, poor dietary intakes, low levels of nutrition-related KAP, and lack of dietary diversity could contribute to the high levels of food insecurity among under-five children.

Association of Household Food Insecurity With Dietary Intakes and Nutrition-Related Knowledge, Attitudes, and Practices Among School-Aged Children in Gaza Strip, Palestine.

Background: The present study aimed to determine the association of household food insecurity with dietary intakes and nutrition-related knowledge, attitudes, and practices (KAP) among school-aged children. Methods: This cross-sectional study was conducted among a representative sample of school-aged children. A total of 380 children and their parents were selected from all Gaza strip governorates, using a random sampling method. The demographic and socioeconomic characteristics; the Radimer/Cornell food security scale; two non-consecutive days of 24-h dietary recall; anthropometric measurements; and the Food and Agriculture Organization KAP-questionnaire (Module 3) were employed. Statistical analysis was performed using SPSS version 25. Results: About 71.6% of school-aged children were household food-insecure, while 28.4% were household food-secure. Significant associations were found between living area, educational level, household monthly income, weight for age and BMI for age z-scores, underweight, malnutrition status, intakes of protein, iron, vitamin D, and zinc among household food-secure, and household food-insecure. After adjustment for confounding variables, having nutrition-related adequate KAP were associated with lower odds of being food-insecure household [OR = 0.519, 95% (CI = 0.320-0.841)], [OR = 0.510, 95% CI = (0.315-0.827)], and [OR = 0.466, 95% CI = (0.285-0.763), P < 0.05 for all], respectively. Conclusions: Low socioeconomic status, low anthropometric indices, poor dietary intakes may be associated with a high level of food-insecurity; while having nutrition-related adequate KAP may be protective against food-insecurity among school-aged children.

Attitudes and Satisfaction toward the Taken Procedures to Tackle COVID-19 Pandemic in Palestine.

BACKGROUND: Since the beginning of the COVID-19 pandemic, there have been differences in the mitigation strategies implemented by governments worldwide. In addition, people's acceptance and adherence to these strategies, such as avoiding large gatherings and shelter in place, varied. The current study aims to assess the attitude and satisfaction with the procedures to tackle COVID-19 in Palestine. METHODS: This cross-sectional descriptive study was conducted in the Palestinian territories, including, Gaza Strip, West Bank, and East Jerusalem, between April 29, 2020, and June 5, 2020, using a validated online questionnaire. The questionnaire included three sections: socio-demographic characteristics, attitude towards the measures and behaviors to avoid COVID-19 infection and its consequences, and level of people satisfaction with the response of the community and local authorities to combat the COVID-19 pandemic. A convenience sampling method was used to select participants. Statistical analysis was performed using SPSS version 26. RESULTS: A total of 570 adults aged ≥18 years (56.3% males and 43.7% females) were included in the study. The mean positive attitude score (average % agree or strongly agree) was 94.22%; 95.24%, 95.18%, and 92.18% in the Gaza Strip, West Bank, and East Jerusalem, respectively. While, the mean satisfaction score was 44.26%, distributed as 47.16%, 46.1%, and 39.22% in the Gaza Strip, West Bank, and East Jerusalem, respectively. Additionally, there were statistically significant variations by most attitude and satisfaction variables across the governorates included in the study (p < 0.05). The current study demonstrated high levels of positive attitude but suboptimal level of satisfaction toward the taken procedures to tackle COVID-19 in Palestine. CONCLUSIONS: Varied implementation strategies to improve the levels of satisfaction toward the approaches to combat the COVID-19 pandemic are recommended.

The fear of COVID-19 outbreak among health care professionals in Gaza Strip, Palestine.

INTRODUCTION: The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals, particularly among healthcare professionals. The present study aimed to assess the fear of COVID-19 among different healthcare professionals in the Gaza Strip, Palestine. METHODS: A cross-sectional, snowball sampling technique and an online questionnaire were employed among healthcare professionals. A total of 300 participants completed the questionnaire. The validated fear of COVID-19 Scale Arabic version was used. Statistical analysis was performed using SPSS version 22. RESULTS: The sample fear mean score was 17.53 ± 5.78; more than half of the study participants (54.3%) consider it as low levels of fear and 45.7% of the participants consider it as high levels of fear. Statistically significant differences were found between males and females, and different healthcare professional's disciplines. Females have a higher mean score compared to males. The highest fear mean scores were found among Lab-Technicians (20.19 ± 7.42), followed by X-ray-Technicians (17.95 ± 3.96), Nurses (17.1 ± 5.55), and Physicians (16.25 ± 4.66). CONCLUSION: The fear of COVID-19 was high among female healthcare professionals compared to males, as well as, among Lab-Technicians compared to Physicians and Nurses. There is a need to establish a strategy to continues measuring the psychological effect of COVID-19 among healthcare professionals especially females.

Impact of the coronavirus disease 2019 pandemic on the Palestinian family: A cross-sectional study.

INTRODUCTION: The current study aims to understand and assess the consequences of the coronavirus disease 2019 pandemic on Palestinian families. METHODS: This online community-based cross-sectional descriptive study was conducted between 19 April 2020 and 5 June 2020, using a validated questionnaire. The questionnaire comprised of three sections: sociodemographic characteristics, living conditions, and impact of the coronavirus disease 2019 pandemic. A convenience sampling method was used to select participants. RESULTS: A total of 570 adults aged ⩾18 years participated in the study. Of them, 258 (45.3%), 120 (21%), and 192 (33.7%) were residing in the Gaza Strip, West Bank, and East Jerusalem, respectively. A large portion of participants (73.2%) reported that the containment measures of the coronavirus disease 2019 pandemic had caused an excessive burden on their families; 549 (96.3%) revealed that water supplies were not always available at home. However, paying attention to personal hygiene and home cleaning was more than usual before the announcement of the coronavirus disease 2019 pandemic. The mean times of going out of their homes have dropped significantly following the onset of the pandemic, p value = 0.001 (95% confidence interval). In addition, 192 (33.7%) participants reported that they changed to working remotely from home with 66 (11.6%) having lost their employment. CONCLUSION: The coronavirus disease 2019 pandemic was associated with an additional burden on the Palestinian families. Moreover, we suggest discussing the obtained results with local and national stakeholders to ensure that they know to improve their actions.

Barriers toward the practice of healthy behaviors among patients with non-communicable diseases in Gaza Strip, Palestine.

OBJECTIVES: Non-communicable diseases are non-infectious health conditions caused by genetic, physiological, environmental, and behavioral factors. Currently, non-communicable diseases account for almost two-thirds of deaths globally. This study aimed to explore the patients' adherence level to the key recommendations, and the main barriers toward the practice of healthy behaviors among non-communicable diseases patients. METHOD: This cross-sectional study was conducted among a representative sample of non-communicable diseases patients, receiving care in five primary healthcare centers in the Gaza Strip, Palestine. An interview-based questionnaire about demographics, medical history, and barriers toward the practice of healthy behaviors was developed and collected based on the health belief model and the theory of planned behaviors. Independent samples t-test, one-way analysis of variance, chi-square, and Fisher's exact test were used for analysis. RESULTS: Four hundred patients with non-communicable diseases, aged (53.06 ± 10.03) years old, (56.8% females and 43.3% males) were included in this study. The patient's adherence was reported as 50.1%, standard deviation = 18.3 in terms of attended regular physical activity, and 44.0%, standard deviation = 15.4 in terms of eating a healthy diet. The main barriers to being active among patients were lack of accessibility to materials, lack of social support, and lack of reminder; while in terms of eating a healthy diet were lack of accessibility to materials, lack of social support, and lack of self-efficacy. CONCLUSION: The non-communicable diseases patients' adherence to healthy behaviors is suboptimal. Varied implementation strategies targeting the main barriers are extremely required to enhance the access to physical activity infrastructure, affordable healthy diet options, and to reinforce the change toward healthy behaviors at all levels.

Barriers of Adherence among Palestinian Healthcare Professionals towards the Protocol of Health Education and Counselling on Healthy Behaviours for Non-Communicable Diseases.

BACKGROUND: Despite the huge numbers of the universally produced and employed protocols, the adherence with them is still low to moderate in the healthcare settings. This study was employed to assess the attitudes of Palestinian healthcare professionals in Gaza Strip to health education and counseling on healthy behaviours protocol (WHO-PEN Protocol 2), for patients with non-communicable diseases in the Ministry of Health primary healthcare centers. METHODS: This cross-sectional study was conducted with a census sample of all governmental family physicians and nurses (n=175). The study questionnaire was developed based on Cabana theoretical framework. The Arabic version questionnaire was developed based on the cross-cultural adaptation framework. The psychometric properties of the Arabic version questionnaire was finally evaluated. RESULTS: The psychometric properties of the Arabic version questionnaire showed good construct validity and internal consistency reliability. The overall adherence level to WHO-PEN Protocol 2 was 70.0, SD=6.9. The main perceived barriers were lack of incentive, patients' factors, and lack of time. In general, most of healthcare professional respondents had a positive attitude toward the protocol, but this attitude was not predictor to protocol adherence. CONCLUSION: The good validity and reliability of the questionnaire can provide support for the accuracy of the study results. Varied implementation strategies targeting the major barriers derived from the study are extremely required for addressing the lack of incentives, patients' factors and time constraints.

The Association between Changes in Coronary Artery Calcium Scores, Dietary Intake, Physical Activity, and Depression Symptoms among the Population of Gaza Strip, Palestine.

BACKGROUND: This study aimed to identify the association between macronutrient intake, physical activity, and depressive symptoms and changes in coronary artery calcium score among the population of Gaza Strip. METHOD: The study sample consisted of 269 individuals who underwent non-enhanced coronary computed tomography using 64-slice MDCT (Siemens, Germany) at Al-Shifa medical complex between September 2017 and January 2018. The study participants were divided into two groups; group one, consisting of coronary calcium calcification scoring (CAC) of greater than zero (CAC score > 0), and group two, CAC less than or equal to zero (CAC score ≤ 0). Data about macronutrient intake, physical activity, and depressive symptoms were collected using a validated self-administered questionnaire. Additionally, the participants' anthropometric characteristics and blood biochemical markers were measured. RESULTS: Out of 269 participants, 45-recorded CAC score > 0; 72% of them were males with a mean age of 52.6 ± 5.4 years. Significant differences between the two groups in terms of total energy, lipid intake, and carbohydrate were found (P-value of 0.020, 0.012, and 0.034, respectively). No significant differences were recorded in protein intake, physical activity, and depression. Multivariate logistic regression analysis under adjustment for possible confounding factors revealed that macronutrient intake, physical activity, and depressive symptoms were not associated with the development of CAC in two models. CONCLUSION: Based on our findings, macronutrient intake, physical activity, and depressive symptoms are not associated with the development of CAC among the population of Gaza.

Public Sector Capacity to Prevent and Control of Noncommunicable Diseases in Twelve Low- and Middle-Income Countries Based on WHO-PEN Standards: A Systematic Review.

This review was conducted to assess the capacity of the public sector to prevent and control noncommunicable diseases (NCDs) in low-and middle-income countries (LMIC) based on WHO-PEN standards. A PRISMA systematic search appraisal of PubMed, Scopus, and Embase was conducted during May-2020 for original articles conducted in LMIC and reported the capacity of the public sector to prevent and control NCDs. The country readiness score was calculated as the mean score of items for each domain. The indices were compared to an agreed cutoff at 80% the WHO optimal target of availability of affordable essential medicines and basic technologies required to treat NCDs. The literature search yielded 5 original studies, conducted in twelve countries, and surveyed 304 public health facilities. All countries failed to reach the WHO optimal target of availability of affordable essential medicines and basic technologies. The readiness index score according to WHO-PEN standards among countries in terms of essential medicines, diagnostic investigations, and basic equipment were range from 13.5% to 51%, 0.0% to 59.4%, and 29.2% to 51.2% respectively. This review revealed critical gaps in the twelve LMIC public sector capacity to prevent and control of NCDs in terms of essential medicines, basic equipment, and diagnostic investigations.

Effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients in the Kurdistan region of Iraq.

OBJECTIVE: This study was employed to assess the effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients. METHOD: This cross-sectional study was conducted among a representative sample, which was selected using a census survey of hypertensive patients (both gender, aged 25-50 years, on regular antihypertensive drugs (atenolol: 50 mg orally once a day)), during Ramadan month that was falling in April to May 2020. The patients were receiving care at Halabja hospital in the Kurdistan region of Iraq. All patients were assessed in two phase's baseline (a week before Ramadan) and end stage (a week after Ramadan), using anthropometric indices, physical examination, biochemical tests, and a structured questionnaire. Statistical analysis was performed using SPSS version 21. RESULTS: A total of 120 hypertensive patients were included in the study (50% females and 50% males), with a mean age of 37.5 ± 6.6 years. The major finding of our study was the significant decrease in blood pressure (P < 0.001). Furthermore, the body weight, body mass index, and waist circumference of the participants decreased after Ramadan fasting in a significant approach (P < 0.001 for all). However, for the lipid profile components, the total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol change persisted not statistically significant (P > 0.05), while only triglyceride decreased drastically after Ramadan fasting (P < 0.001). CONCLUSION: Ramadan fasting could contribute in the improvement of blood pressure and lowers triglyceride levels, body weight, body mass index, and waist circumference of adult hypertensive patients.

Dietary Pattern and Their Association With Level of Asthma Control Among Patients With Asthma at Al-Shifa Medical Complex in Gaza Strip, Palestine.

BACKGROUND: This study was conducted to identify major dietary patterns and their association with level of asthma control among patients with asthma in Gaza Strip, Palestine. METHODS: This cross-sectional study was conducted among a representative sample of Palestinian patients with asthma (both sex, aged 19-64 years) receiving care in chest department at Al-Shifa Medical Complex. Asthma control level was obtained using asthma control test. Data regarding other variables were obtained using an interview-based questionnaire and a semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20. RESULTS: Two major dietary patterns were identified including (1) Prudent pattern characterized by a high intake of whole grains, beans and legumes, fish and shellfish products, vegetables, tomatoes, fruits, and vegetable oils, and (2) Western pattern characterized by a high intake of refined grains, red meat, poultry, fast foods, eggs, low-fat dairy product, high-fat dairy products, hydrogenated fats, olive, sugar, sweets, desserts, and snacks. After adjustment for confounding variables, patients in the lowest tertile (T1) of Prudent pattern had a lower odds for poorly controlled asthma (odds ratio [OR] = 0.044, 95% confidence interval [CI] = [0.002-1.316], P value < 0.05), whereas patients in the lowest tertile (T1) of Western pattern had a higher odds for poorly controlled asthma (OR = 2.499, 95% CI = [1.288-4.850], P value < 0.05), compared with those in the highest tertile (T3). CONCLUSION: A Prudent pattern may be associated with a lower prevalence of poorly controlled asthma, whereas a Western pattern may be associated with a higher prevalence of poorly controlled asthma.

Association of dietary patterns with diabetes complications among type 2 diabetes patients in Gaza Strip, Palestine: a cross sectional study.

BACKGROUND: The prevalence of diabetes mellitus is rising worldwide. When diabetes is uncontrolled, it has dire consequences for health and well-being. However, the role of diet in the origin of diabetes complications is not understood well. This study identifies major dietary patterns among type 2 diabetes patients and its association with diabetes complications in Gaza Strip, Palestine. METHODS: This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20-64 years), patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Additional information regarding demographic and medical history variables was obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 20. RESULTS: Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the lowest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruit had a lower odds for (High BP, kidney problems, heart problems, extremities problems and neurological problems), (OR 0.710 CI 95% (.506-.997)), (OR 0.834 CI 95% (.700-.994)), (OR 0.730 CI 95% (.596-.895)), (OR 0.763 CI 95% (.667-.871)) and (OR 0.773 CI 95% (.602-.991)) respectively, (P value <0.05 for all). No significant association was found between the sweet-soft drinks snacks pattern with diabetes complications. CONCLUSION: The Asian-like pattern may be associated with a lower prevalence of diabetes complications among type 2 diabetes patients.

Dietary Patterns and Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine.

BACKGROUND: The prevalence of metabolic syndrome is raising worldwide; however, the role of diet in the origin of metabolic syndrome is not understood well. This study identifies major dietary patterns among type 2 diabetes mellitus patients with and without metabolic syndrome; and its association with metabolic syndrome components in Gaza Strip, Palestine. METHODS: This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20 - 64 years) patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Metabolic syndrome was defined based on the International Diabetes Federation criteria; dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20. RESULTS: Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the highest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruithad a lower odds for (Metabolic syndrome, central obesity, high triglycerides, low HDL cholesterol and high blood pressure), (OR 0.766 CI 95% (.642-.914)), (OR 0.797 CI 95% (.652-.974)), (OR 0.791 CI 95% (.687-.911)), (OR 0.853 CI 95% (.743-.978)) and (OR 0.815 CI 95% (.682-.973)) respectively, (P value < 0.05 for all). No significant association was found between the sweet-soft drinks-snacks pattern with metabolic syndrome and its components. CONCLUSION: The Asian-like pattern may be associated with a lower prevalence of metabolic syndrome and its components among type 2 diabetes patients.