Evaluación de las conductas de lactancia materna y las prácticas de alimentación complementaria de las madres turcas y las madres refugiadas sirias / Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers

Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

A study on the epidemiology of COVID-19 in the Banias and Alkadmos areas of Syria during 2021

Aims@#Coronavirus disease-2019 (COVID-19) is an ongoing global pandemic. In Syria, the first case was reported in March 2020. This study was aimed to investigate the incidences of COVID-19 in the Banias and Alkadmos areas in Tartus, Syria, in 2021.@*Methodology and results@#Our data were obtained from the records of Banias and Alkadmos hospitals. The results were inferred by analysing data for 1026 COVID-19 patients. About 58.4% of total cases were among males and 41.6% were among females. Most patients were living in rural areas; 73% compared to 27% in urban ones. The severity of the disease varied between patients. About 67.4% of cases needed to be hospitalized for treatment, most of which were from the elderly. The same was noticed with the mortality rate, with 14.5% of total cases and 66.4% of them were older than 65.@*Conclusion, significance and impact of study@#Our study indicated that age and gender are risk factors for contracting COVID-19.

Knowledge and awareness level of syrian dentists towards novel coronavirus pandemic: cross-sectional study / Nivel de conocimiento y actitud de los dentistas sirios sobre la nueva pandemia de coronavirus: estudio transversal

Objetive: An outbreak of a novel and alarmingly coronavirus disease (COVID-19) was announced in China in December 2019, which later affected about 180 countries worldwide. Thus, this study aims to assess the awareness and attitude of dentists towards COVID-19 in Syria. Materials and Methods: The questionnaire was an online survey; it contained 19 questions formulated based on the information given by WHO and CDC for COVID-19. Study participants were dentists practicing in Syria. The questionnaire was translated into Arabic and published on the internet into multiple platforms. Results:7233 dentists responded to the questionnaire; 64% of the participants were females. The majority of the respondents were general practitioner (78%), nearly half of the respondents had been practicing dentistry for at least 2-4 years (51%). The majority of the respondents has knowledge about COVID-19 and was aware it is contagious. Over half of the Syrian dentists received their information about COVID-19 from social media platforms (55%). Even though the majority of the dentists were aware that the incubation period could last up to 14 days, nearly half of the participants were not aware that symptomless patients can spread the virus (49%). Conclusions: Syrian dental practitioners were aware of COVID-19 definition, incubation period and prevention measures in the dental clinic. However, they had limited attitude regarding COVID-19 symptoms, mode of transmission and management.

Objetivos: En China se anunció en diciembre de 2019 un brote de una nueva y alarmantemente enfermedad por coronavirus (COVID-19), que luego afectó alrededor de 180 países en todo el mundo. Por lo tanto, este estudio tiene como objetivo evaluar el conocimiento y la actitud de los dentistas hacia COVID-19 en Siria. Material y Métodos: El cuestionario se aplicó como una encuesta en línea; contenía 19 preguntas formuladas en base a la información proporcionada por la OMS y los CDC para COVID-19. Los participantes del estudio fueron dentistas que practicaban en Siria. El cuestionario fue traducido al árabe y publicado en Internet en múltiples plataformas. Resultado: 7233 dentistas respondieron al cuestionario; El 64% de los participantes eran mujeres. La mayoría de los encuestados eran dentistas generales (78%), casi la mitad de los encuestados habían estado practicando odontología durante al menos 2-4 años (51%). La mayoría de los encuestados tiene conocimiento sobre COVID-19 y sabía que es contagioso. Más de la mitad de los dentistas sirios recibieron su información sobre COVID-19 de redes sociales (55%). Aunque la mayoría de los dentistas sabían que el período de incubación podría durar hasta 14 días, casi la mitad de los participantes no sabían que los pacientes sin síntomas pueden transmitir el virus (49%). Conclusion:Los odontólogos sirios conocían la definición de COVID-19, el período de incubación y las medidas de prevención en la clínica dental. Sin embargo, tenían una actitud limitada con respecto a los síntomas de COVID-19, el modo de transmisión y el manejo.

Sírios e libaneses no oeste paulista - décadas de 1880 a 1950 / Syrian and Lebanese in Western São Paulo / Sirios y libaneses en el oeste de San Pablo

O artigo busca explorar os condicionantes e características distintivas da inserção socioeconômica de sírios e libaneses no interior paulista, entre as décadas de 1880 e 1950. Do início difícil como mascates, portadores de uma cultura distante, os sírios e libaneses lograram se firmar como comerciantes, aproveitando as oportunidades que suas redes (de parentes e conterrâneos) e a economia cafeeira em expansão ofereciam, estabelecendo-se sobretudo nos ramos de roupas, tecidos e armarinhos de secos e molhados e de gado e cereais. Tomando como fonte principal uma série de obras - acadêmicas e memorialísticas -, nas quais o imigrante sírio e libanês é retratado no interior, o artigo indica ainda as principais regiões do oeste paulista nas quais o grupo se concentrou, discute trajetórias que ilustram algumas das possibilidades de mobilidade, a formação de lideranças, o modo como as práticas religiosas se transformaram e a mobilidade acentuada - como doutores e políticos - conquistada por estratos da primeira geração nascida no Brasil.

The article seeks to explore the conditions and distinctive characteristics of the socioeconomic insertion of Syrians and Lebanese in the interior of São Paulo between the 1880s and 1950s. From the difficult beginning as peddlers with a distant culture, Syrians and Lebanese managed to establish themselves as merchants, seizing the opportunities that their networks (of relatives and of countrymen) and the expanding coffee economy offered, establishing themselves mainly in the sectors of clothing, linen and fabrics, cattle and cereals. Taking as main source a series of works in which the Syrian and Lebanese immigrants are portrayed in the interior, the article also indicates the main regions of west of São Paulo where the group mainly concentrated, and discusses trajectories which illustrate some of the possibilities of mobility, formation of leadership, the way religious practices have been transformed and the marked mobility - as doctors and politicians - achieved by strata of the first generation born in Brazil.

El artículo busca explorar los condicionantes y las características distintivas de la inserción socioeconómica de sirios y libaneses en el interior paulista entre la década del ochenta del siglo XIX y la del cincuenta del siglo XX. Del inicio difícil como vendedores ambulantes, portadores de una cultura distante, los sirios y libaneses lograron establecerse como comerciantes, aprovechando las oportunidades que sus redes;de parientes y de compatriotas; y que la economía cafetalera en expansión ofrecía se establecieron sobre todo en las ramas de ropa y tejidos, de mercería, y de ganado y cereales. Tomando como fuente principal una serie de obras en las que el inmigrante sirio y libanés es retratado en el interior, el artículo indica además las principales regiones del oeste paulista en las que el grupo se concentró, discute trayectorias que ilustran algunas de las posibilidades de movilidad, la formación de los líderes, el modo en que las prácticas religiosas se transformaron y la movilidad acentuada;como doctores y como políticos; conquistada por estratos de la primera generación nacida en Brasil.

Obstetric outcomes among syrian refugees: A comparative study at a tertiary care Maternity Hospital in Turkey

Abstract Objective The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women. Methods Retrospective, observational study. A total of 576 Syrian refugees and 576 ethnic Turkish women were included in this study, which was conducted between January 2015 and December 2015 at a tertiary maternity training hospital in Ankara, Turkey. The demographic characteristics, obstetric and neonatal outcomes were compared. The primary outcomes were pregnancy outcomes and cesarean rates between the groups Results The mean age was significantly lower in the refugee group (p< 0.001). Mean gravidity, proportion of adolescent pregnancies, proportion of pregnant women aged 12 to 19 years, and number of pregnancies at < 18 years were significantly higher among the refugee women (p< 0.001). Rates of antenatal follow-up, double testing, triple testing, gestational diabetes mellitus (GDM) screening, and iron replacement therapy were significantly lower in the refugee group (p< 0.001). The primary Cesarean section rate was significantly lower in the refugee group (p= 0.034). Pregnancies in the refugee group were more complicated, with higher rates of preterm delivery (< 37 weeks), preterm premature rupture of membranes (PPROM), and low birth weight (< 2,500 g) when compared with the control group (4.2% versus 0.7%, p< 0.001; 1.6% versus 0.2%, p= 0.011; and 12% versus 5.8%, p< 0.001, respectively). Low education level (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.5-0.1), and weight gain during pregnancy (OR = 1.7, 95% CI = 0.5-0.1) were found to be significant indicators for preterm birth/PPROM and low birthweight. Conclusion Syrian refugees had increased risks of certain adverse obstetric outcomes, including preterm delivery, PPROM, lower birth weight, and anemia. Several factors may influence these findings; thus, refugee women would benefit from more targeted care during pregnancy and childbirth.

Assessment of the perioperative period in civilians injured in the Syrian Civil War / Avaliação do período perioperatório em civis feridos na Guerra Civil Síria

BACKGROUND: wars and its challenges have historically afflicted humanity. In Syria, severe injuries occurred due to firearms and explosives used in the war between government forces and civilians for a period of over 2 years. MATERIALS AND METHODS: the study included 364 cases, who were admitted to Mustafa Kemal University Hospital, Medicine School (Hatay, Turkey), and underwent surgery. Survivors and non-survivors were compared regarding injury site, injury type and number of transfusions given. The mortality rate found in this study was also compared to those reported in other civil wars. RESULTS: the mean age was 29 (3-68) years. Major sites of injury included extremities (56.0%), head (20.1%), abdomen (16.2%), vascular structures (4.4%) and thorax (3.3%). Injury types included firearm injury (64.4%), blast injury (34.4%) and miscellaneous injuries (1.2%). Survival rate was 89.6% while mortality rate was 10.4%. A significant difference was observed between mortality rates in this study and those reported for the Bosnia and Lebanon civil wars; and the difference became extremely prominent when compared to mortality rates reported for Vietnam and Afghanistan civil wars. CONCLUSION: among injuries related to war, the highest rate of mortality was observed in head-neck, abdomen and vascular injuries. We believe that the higher mortality rate in the Syrian Civil War, compared to the Bosnia, Vietnam, Lebanon and Afghanistan wars, is due to seeing civilians as a direct target during war.

JUSTIFICATIVA: Historicamente, as guerras e seus desafios afligem a humanidade. Na Síria, lesões graves ocorreram devido às armas de fogo e explosivos usados na guerra entre as forças governamentais e civis durante um período de mais de dois anos. MATERIAIS E MÉTODOS: O estudo incluiu 364 pacientes, admitidos no Hospital da Universidade Mustafa Kemal da Faculdade de Medicina (Hatay, Turquia) e submetidos à cirurgia. Os sobreviventes e não sobreviventes foram comparados quanto ao local e tipo da lesão e número de transfusões administradas. A taxa de mortalidade encontrada neste estudo também foi comparada àquelas relatadas em outras guerras civis. RESULTADOS: A média de idade foi de 29 (3-68) anos. Os principais locais de lesão incluíram extremidades (56,0%), cabeça (20,1%), abdome (16,2%), estruturas vasculares (4,4%) e tórax (3,3%). Os tipos de lesões incluíram ferimento de arma de fogo (64,4%), lesão causada por explosão (34,4%) e ferimentos diversos (1,2%). A taxa de sobrevivência foi de 89,6%, enquanto a taxa de mortalidade foi de 10,4%. Observou-se uma diferença significativa entre as taxas de mortalidade neste estudo e aquelas relatadas para as guerras civis da Bósnia e Líbano; e a diferença ficou extremamente significativa quando comparada com as taxas de mortalidade relatadas para as guerras civis do Vietnã e do Afeganistão. CONCLUSÃO: Dentre as lesões relacionadas à guerra, a maior taxa de mortalidade foi observada em lesões de cabeça-pescoço, abdome e vasculares. Acreditamos que a maior taxa de mortalidade na Guerra Civil da Síria, em comparação com as guerras da Bósnia, Vietnã, Líbano Afeganistão, se deva ao fato de os civis terem sido vistos como alvo direto durante a guerra.

Starvation of children in Syria – sanctions and the politics of revenge.

As Syria completes two years of western sanctions (2011–13), their dramatic effects on health are being highlighted with first reports of starvation deaths among children in the suburbs of Damascus. Although heavy fighting has taken place in this area, experts had predicted for some time the unworkability of sanctions for regime change, arguing that only civilians would pay the price in a country (Syria in this case) which was once well on the way to meeting the Millennium Development Goals 4 targets on reducing child mortality. In this, as in the case of other "sanctioned" countries, it is not just "civilians" but the most vulnerable among them – children, who are experiencing the tragic consequences of sanctions.

Associação do alelo HLA-DRB1 com suscetibilidade a artrite reumatoide e gravidade da doença na Síria / HLA-DRB1 allele association with rheumatoid arthritis susceptibility and severity in Syria

INTRODUÇÃO: A artrite reumatoide (AR) é uma doença crônica multifatorial complexa. A importância do sistema de antígenos leucocitários humanos (HLA) como fator significativo de risco genético para AR foi estudada no mundo. Embora amplamente distribuídos em diferentes áreas na Síria, faltam estudos sobre o papel dos HLA. OBJETIVO: O objetivo de nosso estudo foi determinar a associação dos alelos HLA-DRB1 com a suscetibilidade a AR e sua gravidade na Síria. PACIENTES E MÉTODOS: Foram genotipados 86 pacientes com AR e 200 controles normais, usando-se reação em cadeia da polimerase com sequência de primer específico (PCR-SSP). Anticorpos anti-CCP foram determinados por ELISA. Fator reumatoide (FR), proteína C-reativa (PCR), velocidade de hemossedimentação (VHS) e o índice de atividade da doença (DAS-28) foram obtidos nos registros médicos e utilizados para avaliar a gravidade clínica dos pacientes. RESULTADOS: Os alelos HLA-DRB1 *01, *04 e *10 mostraram forte associação com suscetibilidade à doença (OR = 2,29, IC 95% = 1,11-4,75, P = 0,022; OR = 3,16, IC 95% = 2,08-4,8, P < 0,0001; e OR = 2,43, IC 95% = 1,07-5,51, P = 0,029, respectivamente), enquanto a frequência dos alelos HLA-DRB1 *11 e *13 foi significativamente mais baixa nos pacientes com AR do que nos controles (OR = 0,49, IC 95% = 0,3-0,8, P = 0,004; OR = 0,32, IC 95% = 0,15-0,69, P = 0,002, respectivamente). Os outros alelos HLA-DRB1 mostraram diferença significativa. A frequência dos anticorpos anti-CCP foi maior em pacientes epítopo compartilhado (EC) positivos do que em pacientes EC-negativos (OR = 5,5, IC 95% = 2-15,1, P = 0,00054). O índice DAS-28 de pacientes com AR não mostrou diferença significativa entre os grupos EC-negativo e EC-positivo. CONCLUSÃO: Nossos resultados indicam que os alelos HLA-DRB1 *01, *04 e *10 estão relacionados com AR, enquanto os alelos HLA-DRB1 *11 e *13 protegem a população síria contra a AR.

INTRODUCTION: Rheumatoid arthritis (RA) is a complex multifactorial chronic disease. The importance of human leukocyte antigen as a major genetic risk factor for RA was studied worldwide. Although it is widely distributed in different Syrian areas, studies of human leukocyte antigen (HLA) alleles' role are absent. OBJECTIVE: The aim of our study was to determine the association of HLA-DRB1 alleles with the susceptibility and severity of RA in Syria. PATIENTS AND METHODS: Eightysix RA patients and 200 healthy controls from Syria were genotyped using polymerase chain reaction with sequencespecific primer (PCR-SSP). Anti-CCP antibodies were measured by ELISA. Rheumatoid factor (RF), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and disease activity score 28 (DAS-28) values were obtained from patients' medical records. DAS-28 was used to assess the clinical severity of the patients. RESULTS: The HLA-DRB1*01, *04, and *10 frequencies showed a strong association with the disease susceptibility (OR = 2.29, 95% CI = 1.11-4.75, P = 0.022; OR = 3.16, 95% CI = 2.0 -4.8, P < 0.0001; OR = 2.43, 95% CI = 1.07-5.51, P = 0.029 respectively), while the frequencies of HLA-DRB1*11, and *13 were signifi cantly lower in RA patients than in controls (OR = 0.49, 95% CI = 0.3-0.8, P = 0.004; OR = 0.32, 95% CI = 0.15-0.69, P = 0.002, respectively). The other HLA-DRB1 alleles showed no signifi cant difference. The frequency of anti-CCP antibodies was higher in shared epitope (SE) positive patients compared with SE-negative patients (OR = 5.5, 95% CI = 2-15.1, P = 0.00054). DAS-28 of RA patients didn't show signifi cant difference between the SE negative and the SE positive groups. CONCLUSION: Our results indicate that HLA-DRB1*01, *04, and *10 alleles are related with RA, while HLA-DRB1*11 and *13 protect against RA in the Syrian population.

Urinary Schistosomiasis: A Case Report / 대한비뇨기과학회지

Urinary schistosomiasis(bilharziasis), caused by digenetic bloodfluke, is an endemic disease in Africa, Yemen, Saudi Arabia, Israel, Lebanon, Syria and Iran, but not in Korea. We report one case of urinary schistosomiasis in Korea, who worked in North Yemen, with the review of literatures.