Validation of an Arabic version of the Yale Food Addiction Scale 2.0

Background: The Yale Food Addiction Scale [YFAS] is the gold standard for assessment of food addiction based on the Diagnostic and Statistical Manual of Mental Disorders [DSM]. To keep up with the DSM-5 update, the YFAS 2.0 was published in early 2016.

Aims: We conducted the present study to translate, adapt and validate the DSM-5 Yale Food Addiction Scale 2.0 for use with Arabic speakers.

Methods: Both the final YFAS 2.0-A, developed with a rigorous methodology, and the English YFAS 2.0 were completed by 236 Egyptian medical students fluent in English and Arabic. Three weeks later, the YFAS 2.0–A was readministered to all participants.

Results: Cronbach's alpha for the YFAS 2.0–A was 0.89. The 3-week intraclass correlation coefficients for diagnosis and symptom scores were 0.95 and 0.93, respectively. Weighted kappa statistics ranged from 0.66 to 0.95 [P < 0.001].

Conclusions: Our findings indicate that the Arabic YFAS 2.0-A is a reliable tool, and that it is valid for use as equivalent to the English YFAS 2.0 in the investigation of food addiction among Arabic-speaking populations.

germline RET proto-oncogene mutation in [G] multiple members of an Arab family with variable onset of MEN type 2A-associated clinical manifestations

Background: Multiple endocrine neoplasia type 2A [MEN2A] is a rare cancer associated-syndrome, inherited in an autosomal dominant fashion and caused by germline mutation in RET proto-oncogene

Clinical diagnosis depends on the manifestation of two or more certain noma; endocrine tumors in an individual, such as medullary thyroid carcinoma, pheochromocytoma, MEN2A; and parathyroid adenoma or hyperplasia. Prophylactic total thyroidectomy with central neck Pheochromocytoma; lymph node dissection is mandatory for mutation carriers, with periodic monitoring of the other RET proto-oncogene concerned organs

Subjects and methods: We have screened 27 individuals from a large Arab family with multiple affected members. Mutational screening involved the hotspot regions in the most commonly implicated exons 10 and 11 of RET proto-oncogene using PCR amplification of the coding and the flanking intronic regions followed by the Sanger sequencing

We aimed for confirmation of the clinical diagnosis and identification of at-risk asymptomatic mutation carriers

Results: A pathogenic variant C.1901G > T [p.Cys634Phe], in exon 11 of RET proto-oncogene was identified in 15 members of different ages.

Conclusion: Genetic counseling plays a key role in the management of such high-risk families and hence helps in avoiding or reducing disease recurrence in their future generations

Contribution of Arab countries to pharmaceutical wastewater literature: a bibliometric and comparative analysis of research output

BACKGROUND: Recently, the pharmaceutical manufacturing industry has been growing rapidly in many countries in the world, including in Arab countries. Pharmaceuticals reach aquatic environments and are prevalent at small concentrations in wastewater from the drug manufacturing industry and hospitals. Such presence also occurs in domestic wastewater and results from the disposal of unused and expired medicines. Therefore, the objective of this study was to analyze and compare the quantity and quality of publications made by researchers in Arab countries on pharmaceutical wastewater. METHODS: To retrieve documents related to pharmaceutical wastewater, we used the Scopus database on November 21, 2015. All documents with terms related to pharmaceutical wastewater in the title or abstract were analysed. Results obtained from Arab countries were compared with those obtained from Turkey, Iran and Israel. RESULTS: Globally, a total of 6360 publications were retrieved while those from Arab countries, Iran, Turkey and Israel, were 179, 113, 96 and 54 publications respectively. The highest share of publications belonged to Kingdom of Saudi Arabia (KSA) with a total of 47 (26.2 %) publications, followed by Egypt (38; 21.2 %), Tunisia (17; 9.5 %) and Morocco (16; 8.9 %). The total number of citations was 1635, with a mean of 9.13 and a median (inter quartile range) of 3 (1.0–10.0). The study identified 87 (48.6 %) documents with 32 countries of international collaboration with Arab countries. It was noted that Arab researchers collaborated mainly with authors in Western Europe (54; 30.2 %), followed by authors from the Asiatic region (29; 16.2 %) and Northern America (15; 8.4 %). The most productive institution was King Saud University, KSA (13; 7.3 %), followed by the National Research Centre, Egypt (10; 7.3 %). CONCLUSIONS: This study showed that KSA has the largest share of productivity on pharmaceutical wastewater research. Bibliometric analysis demonstrated that research productivity, mainly from Arab countries in pharmaceutical wastewater research, was relatively lagging behind. More research effort is required for Arab countries to catch up with those of non-Arab Middle Easter countries on pharmaceutical wastewater research.

Obesity-linked diabetes in the Arab world: a review

The Arab world is experiencing an epidemic of obesity and type 2 diabetes mellitus. This review summarizes the major pathological factors linking obesity to diabetes, focussing on current epidemiological data related to obese diabetic patients in the Arab world, the etiology of the disease and the genetic determinants of diabetes and obesity. There are alarming data related to the rising prevalence of obesity and type 2 diabetes mellitus in children of Arab ethnicity. Replication studies identify several genetic variants in Arabs with obesity-linked diabetes. For example, variants of the ADIPOQ gene [the rs266729 single-nucleotide polymorphism] are associated with obesity and diabetes in various Arab countries. Gaps exist in our information about diabetes and obesity in Arabpopulations in relation to ethnic-specific cut-off points for diagnosis and treatment of diabetes. Further genome-wide association studies in obese and diabetic Arab populations could add to our understanding of the pathophysiology, prevention and reversal of this disease

Hepatitis B virus in the Arab world: where do we stand?

The epidemiology of viral hepatitis is of great importance for planning and managing health provision for all the countries in the Arab world. However, data on viral hepatitis are not readily available in a large percentage of Arab countries. Hepatitis B virus [HBV] is considered to be one of the most important causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma. A systematic electronic search of published literature was conducted to extract data on epidemiology and risk factors for the analysis of HBV infection among the countries in the Arab world. The prevalence of chronic HBV infection was found to be decreasing in some Arab countries although it was still unacceptably high. This was particularly evident in the Arabian Gulf region, in Lebanon, Egypt and Libya. The age-specific prevalence varied from country to country with decline in prevalence being noted among children in the Gulf States and among Libyan women. These declines in prevalence are most likely to be related to the Expanded Immunization Programme. The alarmingly high prevalence of chronically infected patients in some areas and the widespread differences in HBV prevalence between Arab nations may be explained by the variation in risk factors involved. This situation calls for targeted approaches to tackle HBV-related mortality and morbidity. Precise HBV infection prevalence data are needed at the national and the sub-national level to estimate the disease burden, guide health intervention programmes and evaluate vaccine efficiency

Health education materials for Arab patients: content and design preferences

To investigate the content and design preferences of printed health education leaflets among Arab patients. A survey questionnaire to 17 subjects [women: n = 8, men: n = 9; age range 17-70 years] and three focus-group discussions [total 16 participants] were used to assess preferences by showing samples of Arabic health education materials. The questionnaire was administered by interviewers. For the focus-group discussions, the sessions were conducted by a trained interviewer, audio recorded and analyzed thematically. The subjects' educational level was from no formal schooling to university level. In survey component, all patients preferred photographs over clipart. Typeface ['font'] preferences were for Simplified Arabic in 8 subjects [47%] and Mudir MT in 7 [41%]; the 16-point font size was favored by 14 [82%] patients. In the three focus-group discussions, themes that participants expressed included use of standard Arabic with local dialects, short sentences, and culturally appropriate advice with practical and quantifiable examples. The participants preferred health education materials to be color trifold brochures illustrated with pictures and not clipart and written in Arabic using the Simplified Arabic font in 16-point size

Determinants of blood uric acid levels in a dyslipidemic Arab population

The objective of this study was to explore the relationships between circulating uric acid and lipid levels and components of the metabolic syndrome [MetS] in Arab dyslipidemic patients, a group already at high coronary artery disease risk. The medical records of 1,229 subjects [632 men, 597 women] referred for treatment of dyslipidemia and followed up for at least 12 months were reviewed. Serum levels of uric acid and lipids [total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein] and other variables in the National Cholesterol Education Program ATP III criteria definition of MetS were assessed at initial presentation and every 4- 6 months, under specific lipid-lowering treatment [statins and/or fibrates], in each of the subjects. Their respective associations were explored by appropriate logistic regression techniques with control for confounding risk factors, including age, gender and body mass index. 306 subjects [24.9%] of the study population were hyperuricemic; they were more likely to be men, obese and diabetic. Also the serum uric acid level [mean +/- SD] was greater in men with MetS compared with men without [377.0 +/- 98.0 vs. 361.6 +/- 83.1 micro mol/l, p < 0.05], an observation not reproduced in women. Uric acid levels had significant associations with the presence of fasting hyperglycemia, hypertension and large waist circumference [WC] in men, but only with large WC in women. With statin treatment, uric acid levels decreased by 10% within 1 year of treatment; with fibrates, uric acid levels remained unchanged or slightly increased. The data showed that hyperuricemia is common in dyslipidemic patients in Kuwait, where its important determinants are male sex, obesity, diabetes and statin treatment

Health services to groups with special needs in the Arab world: a review

This paper examines the health services provided to the older population [especially those with physical limitations] and the people with mental illnesses in Arab countries and their evolution over the past 3 decades. The paper reviews utilization issues related to morbidity, transportation, patient-provider relationship, cost, stigma and organizational barriers that often impede access and compliance with the care provided or recommended. Health systems in the region need to acknowledge the specific needs of these patients in their national programmes. Raising awareness is an important step in this regard

Historical development of health professions', education in the Arab world

This paper reviews the historical development of health professions'education in the Arab countries and highlights the role that the World Health Organization has played in the support of the health workforce. Challenges such as the migration of health professionals, the need for additional educational opportunities in public health and in the management of health services and the need to adapt education to address the needs of society are discussed. Efforts are needed to develop further the quality and relevance of education and to address the needs of the health systems and the welfare of communities. The production of research in cooperation with policy-makers to enhance decisions and policies based on evidence needs increased attention

Population health genomics in member countries of the cooperation council for the Arab states of the Gulf

The member countries of the Cooperation Council for the Arab States of the Gulf, also known as the Gulf Cooperation Council [GCC], have a diverse population of 35.1 million people and an overall population growth rate of over half a million people a year. The GCC countries have fast-growing economies based mainly on revenues from petroleum and related industrial products. Health services are provided by the government and the private sector, and GCC citizens have no mandatory health insurance plan. Patients incur no cost for government-provided health services at the point of care. Among the distinctive socio-cultural characteristics of GCC countries are marriage at a young age [sometimes at less than 15 years of age], child-bearing until menopause, a high birth rate [16 - 43 births/1000 population], large family size resulting from a high fertility rate [2-7 children per woman], and a high rate of inbreeding or consanguineous marriage [up to 58% of marriages in some areas]. The prevalence of genetic diseases in the GCC countries is high in comparison with rates in Europe and North America. Hemoglobinopathies, G6PD deficiency, inborn errors of metabolism, congenital hypothyroidism, deafness, and Down's syndrome represent the most prevalent genetic diseases in the GCC countries and have been discussed frequently in the literature. Public health activities are resourced by government. Premarital medical counselling is obligatory in Bahrain and Saudi Arabia, while it is encouraged in the rest of the GCC countries. Prenatal screening is offered as part of routine clinical prenatal services. Newborn screening programs vary between GCC countries with respect to organization and the conditions screened for. The many gaps that remain in current screening programs reflect gaps in effective surveillance and a resulting lack of national incidence and prevalence data for certain genetic diseases. The GCC countries as a whole would benefit from the adoption of a comprehensive screening and surveillance framework for genetic diseases. Adequate stakeholder engagement and good communication between medical and public health disciplines is needed for such a framework to be effective. Regular evaluation, dissemination of information, and the application of evidence-based knowledge to the specific needs of the region will be essential to improvements in genetic services

Epidemiologic assessment of substance use in the Arab world

Epidemiological studies on substance use are rare in the Arab world. The purpose of this paper is to present a systematic review of all published epidemiologic research in the Arab world up to 2007 using several search engines such as PubMed, PsycInfo, and IDRAAC web database. Research in the Arab world was conducted on specific subpopulations ranging from students to autopsies, at times on large numbers and only one published article on a national basis. Despite the rigid laws against substance use in this region, alcohol is the most used substance, especially among high school and university students ranging from 4.3% to 70.1%. Males use substances more than females except for tranquilizers and barbiturates, the trends changing in a recent report from the L.E.B.A.N.O.N study. As reported by Western counterparts, substances carry a burden on several levels including social impairment, problems of violence, and HIV. Risk factors for substance use include mainly family problems and peer pressure. However, there remains a clear need for national data on substance use in the Arab world in an attempt to identify the magnitude of the problem, and track it for proper monitoring and intervention

Helicobacter pylori in Arabs; clinical aspects and related diseases in comparative study in three Arabian countries

Helicobacter pylori represents one of the most common infections worldwide. It has been established as an etiologic factor in the development of peptic ulcer disease and chronic gastritis; and associated firmly with development of gastric neoplasia, including gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma. Several extra digestive pathologies have been linked to H. pylori infection including cardiovascular, cutaneous, autoimmune, esophageal and other diseases such as sideropenic anaemia, growth retardation, and extragastric MALT-lymphoma. The aim of this work is to evaluate the contribution of H. pylori infection to the uncommon; digestive and extra-digestive; manifestations of patients in GIT clinics in some Arabian countries. A total of 623 H. pylori positive patients from three Arabian countries including 225 Egyptian patients, 188 Kuwait patients and 210 Saudi patients were studied and evaluated for all the possible manifestations of this infection. Evaluation was done by history, medical examination, routine and specific laboratory investigations, endoscopic and histopathological diagnosis. Follow-up after eradication was done to evaluate the response and improvement of such manifestations. This study included 339 males and 274 females distributed in the three countries. Recurrent H. pylori infection was found in 10.9% of all patients and was significantly more common in Saudi patients and associated with significantly higher incidence of thyroid dysfunction and pancreatitis. Mouth ulcers, vertigo, diabetes, gastric polyps and low serum iron were significantly more common in Egyptian patients than other population. Constipation, history of atypical chest pain, pancreatitis, thyroid dysfunction and ALT elevation were significantly more common in Saudi patients than other populations. Presence of GERD and migraine were found significantly more common in both Saudi and Kuwaiti than Egyptian patients. Diabetes mellitus was one of the commonest associated manifestations in this study and was found in 16.5% of all patients. Duodenal ulcer was found significantly more common in younger age group. Autoimmune haemolytic anaemia was found the only disease associated with significantly higher Cag A positivity. Constipation was also common in this population [11.9% of all patients] and was directly correlated with the presence and severity of gastritis. Pancreatitis was directly correlated with history of past infection, gastric ulcer, GIT malignancy, gastric outlet obstruction, arthritis and skin rash. Low serum iron and hemoglobin were more significant in patients with peptic ulcer disease and GIT malignancy. After eradication of infection, marked improvement during follow-up was noticed in patients with skin rash [28/37], mouth ulcer [37/59], and constipation [51/73] while mild to moderate improvement was noticed in those with migraine [11/260] and vertigo [19/49]. Also, highly significant increase in serum iron and hemoglobin levels [p<0.001] was found in all patients after eradication of infection when analyzed altogether and as separate groups without iron supplementation. The most sensitive and specific diagnostic tests for H. pylori in this cohort was the microscopic examination, followed by rapid urease test; both depend on gastric biopsies. It is concluded from this study that H. pylori infection is present in most Arabian countries nearly with similar, but of somewhat variable extent, manifestations whether digestive or extradigestive. The associated extradigestive manifestations described cannot be attributed to H. pylori in all cases, but it is recommended to screen for this infection and eradicate it particularly if there are additional upper GIT complaints. The presence of GERD should not affect the decision of treatment of this infection. Finally, diagnosis and treatment of H. pylori might be considered in the workup in the management of diseases with autoimmune pathogenesis such as ITP, autoimmune haemolytic anaemia, skin diseases, thyroid dysfunction, diabetes mellitus, and others