Investigating Majhool date (Phoenix dactylifera) consumption effects on fasting blood glucose in animals and humans.

OBJECTIVES: Majhool date (Phoenix dactylifera), renowned for its premium taste and texture, is extensively consumed in the Islamic world, particularly during Ramadan. Despite its popularity, concerns persist regarding its potential to induce diabetes in non-patients. This study aims to explore the diabetogenic effects of prolonged Majhool date (Phoenix dactylifera) consumption, the widely used fruit in the Islamic world, through animal experiments and human clinical data. METHODS: Medjool dates were processed into an ethanolic extract for the animal experiment. Then, 21 Balb/c mice received varying doses of the extract for one month. The fasting blood glucose levels were analyzed at the beginning and after one month of consumption of the Majhool date extract. For the clinical study, 387 healthy participants were recruited, with fasting blood glucose levels assessed before and after Ramadan, a period of heightened Majhool date consumption. RESULTS: all groups of the experimental animals exhibited a significant (p<0.05) weight increase after Majhool date consumption, while no significant (p>0.05) alteration in fasting blood glucose levels among groups. In addition, it was found that fasting blood glucose levels remained statistically unchanged (p>0.05) after heightened Majhool date consumption among humans. CONCLUSIONS: The study challenges the belief that Majhool date induces diabetes, supported by both animal and human data. Findings suggest that Majhool date consumption, even at higher doses, does not induce diabetes. Further investigations could explore the impact of other date varieties on the fasting blood glucose levels.

How does the general population approach their pain? A cross-sectional study in Palestine.

Background: Pain perception and management vary across cultural contexts; yet, little is known about pain approaches in the general population of Palestine. Existing research lacks specific knowledge about how pain is coped with in this region. Objective: To explore pain management among Palestine's general population, studying prevalence, characteristics, and sociodemographic influences. It aims to uncover treatment choices and understand cultural impacts on pain experiences, offering insights into Palestinian pain perception and coping strategies. Methods: Convenience and snowball sampling methods were employed to collect data from 646 adults in Palestine. Participants' sociodemographic characteristics, pain experiences, and pain management strategies were examined. Descriptive statistics, chi-square tests, and binary logistic regression followed by multiple logistic regressions were used for data analysis. Results: A significant portion of participants reported experiencing pain, with chronic pain being predominant. Pain prevalence varied across age groups, with higher rates in the elderly, followed by middle-aged and younger participants. Marital status and education level were linked to pain prevalence. Participants employed diverse pain management strategies, such as self-medication, physician visits, complementary medicine, and physical therapy. Age, gender, marital status, and education level influenced choices in pain management approaches. For instance, the elderly favored traditional medical interventions, while higher education levels were associated with reduced inclination toward conventional treatments. Conclusion: This study underscores the complex interaction of sociodemographic factors, pain experiences, and treatment preferences in pain management. It emphasizes personalized strategies considering age, marital status, education, and gender. Integrating these aspects improves treatment and satisfaction. The findings empower healthcare providers to create precise strategies, enhancing patient experiences for better outcomes.

Medicine and Pharmacy Students' Knowledge, Attitudes, and Practice regarding Artificial Intelligence Programs: Jordan and West Bank of Palestine.

Background: Artificial intelligence (AI) programs generate responses to input text, showcasing their innovative capabilities in education and demonstrating various potential benefits, particularly in the field of medical education. The current knowledge of health profession students about AI programs has still not been assessed in Jordan and the West Bank of Palestine (WBP). Aim: This study aimed to assess students' awareness and practice of AI programs in medicine and pharmacy in Jordan and the WBP. Methods: This study was in the form of an observational, cross-sectional survey. A questionnaire was electronically distributed among students of medicine and pharmacy at An-Najah National University (WBP), Al-Isra University (Jordan), and Al-Balqa Applied University (Jordan). The questionnaire consisted of three main categories: sociodemographic characteristics of the participants, practice of AI programs, and perceptions of AI programs, including ChatGPT. Results: A total of 321 students responded to the distributed questionnaire, and 261 participants (81.3%) stated that they had heard about AI programs. In addition, 135 participants had used AI programs before (42.1%), while less than half the participants used them in their university studies (44.2%): for drug information (44.5%), homework (38.9%), and writing research articles (39.3%). There was significantly (48.3%, P<0.005) more conviction in the use of AI programs for writing research articles among pharmacy students from Palestine compared to Jordan. Lastly, there was significantly more (53.8%, P<0.05) AI program use among medicine students than pharmacy students. Conclusion: While most medicine and pharmacy students had heard about AI programs, only a small proportion of the participants had used them in their medical study. In addition, attitudes and practice related to AI programs in their education differs between medicine and pharmacy students and between WBP and Jordan.

Assessment of Perceptions and Predictors Towards Consanguinity: A Cross-Sectional Study from Palestine.

Background/Aim: Consanguinity represents a biological relationship between two individuals. In clinical genetics, it specifically refers to the marriage between individuals who are second cousins or closer. The aim of the study is to assess perceptions and their predictors among the Palestinian population towards consanguinity. Methods: A survey-based cross-sectional study was conducted. The sample was collected using convenience and snowball sampling methods, yielding a sample of 1008 participants. The perceptions towards consanguinity and its predictors were assessed using Chi-square test. Results: The prevalence of consanguinity among married participants was 18.7% (N = 81/432), while it was 28.8% among their parents. Consanguinity rate was significantly low among the young age group (ie, <47 years old) and among participants whose mothers have undergraduate educational levels (P < 0.05). Other factors like parental consanguinity, educational level of participants, their father's educational level, and residency place showed no significant associations (P > 0.05). Rejection of consanguinity was significantly noted among young age participants, absence of parental consanguinity, the presence of children or family members with genetic disorders and female gender (P < 0.001). Furthermore, participants who indicated that they are governmental employees, those with 2000-5000 ILS monthly income, those who are married (P < 0.01), and those who indicated that their mothers are holders of postgraduate degree were significantly more likely to reject the idea of consanguinity (P < 0.05). Also, medical and/or scientific reasons were significantly associated with rejecting the idea of consanguinity (P < 0.001). Conclusion: Consanguinity prevalence has decreased among recent generations in Palestine, but it remains a significant challenge in Palestine. Therefore, educational and awareness programs about consanguinity and its health effects are effective strategies for reducing the consanguinity rate, especially for persons who are at the age of marriage.

Does Ramadan Intermittent Fasting Affect the Fasting Blood Glucose Level among Type II Diabetic Patients?

BACKGROUND: The level of fasting blood glucose (FBG) is influenced by several factors, including health status, genetics, and diet. Some studies have reported a beneficial effect of Ramadan Intermittent Fasting (RIF) on diabetic patients. However, clinical observations have shown that diabetes is exacerbated in some patients. AIM: This study aims to investigate the influence of RIF on the FBG level, a biomarker of hyperglycemia and diabetes, and to identify factors associated with variations in FBG levels during RIF among diabetic patients. METHODS: This study is a cross-sectional study. We monitored the FBG levels of 181 type II diabetic patients over a two-month period, from 20 February to 20 April 2023, which represents the Islamic lunar months of Shaban (8th month) and Ramadan (9th month). Ramadan provides a prominent month of intermittent fasting practice for studying its physiological effects on diabetes. We collected clinical data from each participant, including demographic information, co-morbidities, and medications used during this period. RESULTS: Based on our findings, diabetic patients were classified into three groups depending on the influence of RIF on FBG levels: the positively affected group (44%), whose average FBG levels were reduced; the neutrally affected group (24%), whose average FBG levels did not change; and the negatively affected group (32%), whose average FBG levels increased during the fasting month of Ramadan compared to the previous month. Furthermore, we found that the positive effect of RIF was more frequent among obese, non-geriatric, and male diabetic patients, while the negative effect of RIF was more frequent among patients who were not adhering to the medication. CONCLUSIONS: This study concludes that RIF affects FBG levels differently among diabetic patients. These findings should be taken into consideration when treating diabetic patients during the fasting month of Ramadan, and further studies are needed to identify (1) factors associated with inter-individual variation in the response to RIF and (2) those who are great candidates for RIF.

Knowledge, Attitudes, and Practices of Adult Iraqi Population Towards COVID-19 Booster Dose: A Cross-Sectional Study.

Purpose: COVID-19 vaccines are critical for containing the pandemic and preventing serious SARS-CoV-2 infections. In addition to the two main doses, a booster dose has been utilized to improve immunity. The aim of current study is to evaluate Iraqi adult population knowledge, attitudes, and practices towards COVID-19 booster dose. Subjects and Methods: This online cross-sectional survey of adult Iraqis (n = 754) assessed the attitudes of people who have had both immunizations regarding a potential COVID-19 vaccine booster dosage and to identify potential factors that might impact these attitudes. Factors evaluated in the current study included previously received vaccine type in the first two doses, socioeconomic characteristics, health status, knowledge about COVID-19 and its vaccines and adherence to protective practices. Results: Overall, 61.1% of participants expressed willingness to receive a COVID-19 booster dose, with a high median score of knowledge and practice toward COVID-19. Participants who did not perceive COVID-19 to be serious, p-value <0.001), participants who believed they would not be infected with COVID-19 in the next 6 months (p-value <0.001), low knowledge score group (p-value <0.001), lower education (p-value <0.001), participants who received the COVID-19 vaccine because of imposed laws (p-value <0.001), participants who received AstraZeneca vaccine (p-value <0.001), younger participants (p-value=0.003), low level of practice (p-value <0.001), participants who did not know someone who had died due to COVID-19 (p-value=0.01), low risk of developing serious side effects if infected with COVID-19 and participants in the low side effects score were significantly less frequently willing to receive a booster COVID-19 dose (p-value <0.001). The main reasons for booster dose hesitancy/refusal were the perceived lack of need for a booster shot, the uselessness of a booster shot and the conspiracy theory of boosting corporate profits through booster shots. Conclusion: There is high hesitancy towards COVID-19 booster dose acceptance among the Iraqi population. The study identified several factors associated with vaccine hesitancy including low socioeconomic status and low knowledge about COVID-19 and its vaccines.

Assessment of Alternative Medicine Use, Costs, and Predictors of Medication Adherence among Diabetes Mellitus Patients in Palestine.

BACKGROUND: Diabetes Mellitus (DM) is considered the fourth leading cause of death in Palestine, with a prevalence of 9.1% in patients aged 20-79 years, and is predicted to increase to 20.6% by 2020. AIMS: This study aims to estimate DM costs, compare DM total health care cost among patient characteristics and DM management (e.g. Anti-diabetic medications and alternative medicine), as well as assess MA and its predictors including patient characteristics, DM management, alternative medicine use, and DM costs. METHODS: A cross-sectional study was conducted for the past one year among 479 diabetic patients, selected by convenience sampling and snowball sampling methods via electronic post of an online questionnaire including a web link to the questionnaire page in a Google Form via email or public social media pages and applications. Data on patients' socio-demographic and clinical characteristics, medication profile, use of medicinal plants as alternative medicine, costs, and Medication Adherence (MA) were collected. The Statistical Package for Social Sciences (SPSS v. 25) was used to perform a descriptive, Kolmogorov-Smirnov test, univariate analysis, Mann-Whitney or Kruskal-Wallis test, multiple linear regression, binary logistic regression, and multiple logistic regression analysis. A P value < 0.05 was considered statistically significant. RESULTS: More than half of the participants were male and living in villages (50.7%, 59.1%, respectively). Approximately 51.4% received Oral Hypoglycemic Drugs (OHDs) and only 16.1% received insulin. The participants receiving ≤3 medications daily acquired the highest percentage (55.7%), and less than half received medicinal plants as an alternative medicine for the management of DM. The estimated total DM health care cost per 1 year incurred by patients and family members was Israeli Shekel 988,276 (US Dollar 307,590). More than half of the participants were considered adherent with the Eight-Item Morisky Medication Adherence Scale (MMAS-8) score ≥6. It is noteworthy that the use of alternative medicine was significantly associated with total health care cost and MA. Furthermore, DM duration was significantly associated with MA. These are results worth taking into consideration. CONCLUSION: This study reflects the need for strengthening the patient-health care professionals' relationship, and to enhance the role of preventive education, and the importance of awareness about MA, DSCMBs, and the use of alternative medicine based on evidence-based strategies to improve MA, glycemic control, meanwhile reducing the costs incurred by patients and family members.

The Prevalence of Water Pipe Smoking and Perceptions on its Addiction among University Students in Palestine, Jordan, and Turkey.

BACKGROUND: Understanding the university students' perception of Water Pipe smoking addictions and factors behind the rise in the prevalence of Water Pipe smoking will contribute effectively in the prevention strategies and policies development. AIMS: Thus, this study aims to assess the prevalence of Water Pipe smoking among university students and their perceptions on its addiction in Palestine, Jordan, and Turkey, as an initial step to reduce the spread of Water Pipe smoking. METHODS: An online self-structured questionnaire was administered to 2030 selected university students from Palestine, Jordan, and Turkey. Prevalence, knowledge and other related factors concerning Water Pipe smoking and its addiction were compared between university students from three Middle East countries (Palestine, Jordan, and Turkey) using SPSS software for statistical analysis. RESULTS: The overall prevalence of Water Pipe smoking was 31.8%, less than a quarter of university students (21.7%) had ever smoked Water Pipe. The highest percentage of current Water Pipe smokers were Palestinians (36.11%), and the lowest percentage was from Turkey (20.23%). Approximately 43% of Water Pipe smokers believe that they will be addicted to Water Pipe smoking and almost half of them smoke Water Pipe daily. The highest percentage of smokers were university students 25 years old and above. However, the highest percentage of smokers was low monthly income students. The university students living with their families were smoking Water Pipe less frequently than students living in private residencies. CONCLUSIONS: The prevalence of Water Pipe smoking among university students in Palestine and Jordan was high compared to Turkey. It was believed that the Turkish rules and regulations of Water Pipe smoking limit the Water Pipe smoking in Turkey.
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Attitudes and Acceptance of the Palestinian Population towards COVID-19 Health Precautions and Vaccinations: A Cross-Sectional Study.

BACKGROUND: COVID-19 is a new pandemic and the best protection against this infection is by vaccination. AIMS: To assess the commitment to COVID-19 health precautions and vaccination willingness among the Palestinian population. METHODS: An online-based survey was developed in an observational cross-sectional study. A total of 1367 participants were recruited conveniently between February and June 2021. To carry out comparisons, Mann-Whitney or Kruskal-Wallis was used for numerical variables and chi-square or Fisher's exact for categorical. Multiple logistic regression was used for health precautions and multinomial logistic regression for vaccination willingness. RESULTS: The commitment to the majority of health precautions was predicted by perceiving COVID-19 threat, educational level, and city residency (P < 0.05). Social distancing and sterilizer usage were associated with city residency (P < 0.001). Students, males, and unemployed participants were less committed to health precautions (P < 0.05). Vaccination willingness was less predicted by the perception of an ineffective vaccine (P < 0.001), perceiving no threat of COVID-19 (P < 0.05) or perception of threat for old/or chronic diseases (P < 0.05), employed participants (P < 0.05), without chronic diseases (P < 0.05), and not committed to wearing a mask (P < 0.001). CONCLUSION: COVID-19 threat perception, high education level, and city residency predict more commitment to health precautions, in contrast to male students and unemployed participants. On the other hand, Having no chronic diseases, perception of ineffective vaccines, unperceived COVID-19 threat, and unwillingness to wear masks predicted less vaccination acceptance. Therefore, it is critical to increase awareness about the COVID-19 threat, health precautions, and vaccination efficacy. This study is cross-sectional. Future works concerning changes in Attitudes toward COVID-19 health precautions and vaccination should be encouraged including vaccinated participants.

Parents' attitudes, knowledge and practice towards vaccinating their children against COVID-19: a cross-sectional study.

The question of whether children should be vaccinated against COVID-19 is currently being argued. The risk-benefit analysis of the vaccine in children has been more challenging because of the low prevalence of acute COVID-19 in children and the lack of confidence in the relative effects of the vaccine and the disease. One of the most convincing arguments for vaccinating healthy children is to protect them from long-term consequences. The aim of this study was to assess Jordanian parents' intention to vaccinate their children. This is an Internet-based cross-sectional survey. The researchers prepared a Google Forms survey and shared the link with a number of Jordanian Facebook generic groups. Data were gathered between September and November 2021. In this study, convenience sampling was used. Knowledge about COVID-19 and preventive practices against COVID-19 were calculated for each participant. A total of 819 participants completed the survey (female = 70.9%). Of these, 274 (30.2%) participants intended to vaccinate their children, whereas the rest were either unsure 176 (21.5%) or intended not to vaccinate their children 396 (48.4%). The variables that increased the odds of answering "No" vs "Yes" to "will you vaccinate your children against COVID-19" included not willing to take the vaccines themselves (OR 3.75; CI, 1.46-9.62) and low protective practice group (OR 1.73;CI, 1.12-2.68). Participants had significant levels of refusal/hesitancy. Several barriers to vaccination were identified; attempts to overcome these should be stepped up.

COVID-19 Vaccination Acceptance and Its Associated Factors Among the Iraqi Population: A Cross Sectional Study.

PURPOSE: The Coronavirus Disease 2019 (COVID-19) pandemic poses a serious threat to countless lives. Development of an efficient vaccination can help end the pandemic. Vaccine hesitancy/refusal is a huge issue that could stymie attempts to combat the disease. The goal of this study is to examine COVID-19 vaccine hesitancy in Iraq where at the end of July 2021, only 7.4% of the population was vaccinated. PARTICIPANTS AND METHODS: This is a cross-sectional web-based study. A survey was used to assess knowledge, attitudes and practice (KAP) toward COVID-19. Willingness to be vaccinated against COVID-19 was assessed, with a logistic regression used to identify variables associated with vaccine acceptance. Motives for vaccination refusal/hesitation were reported. RESULTS: A total of 1542 participants (females = 56.7%) completed the questionnaire. Participants displayed high knowledge and good protective practices toward COVID-19 (median score = 15 out of 19 and 20 out of 25 respectively). 88.6% were willing to be vaccinated. Variables associated with vaccine acceptance included have not been infected with COVID-19 (OR=0.53, p=0.01), low- and moderate-income (ORs=0.42 and 0.63, p<0.01 respectively), low education level (OR=0.33, p-value<0.01) and perceived degree of vaccination importance (OR=1.30, P-value<0.01). The most mentioned reasons for vaccine refusal were concerns about vaccine safety and side effects (90.35%) and the need for more information about the vaccine (81.2%). CONCLUSION: Participants showed high acceptance toward COVID-19 vaccination, nevertheless more efforts should be applied to overcome barriers mentioned by the participants.

COVID-19 confinement and related well being measurement using the EQ-5D questionnaire: A survey among the Palestinian population.

PURPOSE: This study aims to assess the effect of the COVID-19 confinement on the population wellbeing using the EQ-5D questionnaire. METHODS: After receiving the written permission from the EuroQol Research Foundation, an online-based survey was prepared and a total of 1380 participants were recruited via social media. The relationships of all the factors were studied as well as the scores of the EQ-5D including EQ-5D Index, Visual Analogue Scale (VAS), and each of the EQ-5D dimension. Linear regression for the Index and VAS and Logistic regression model was used to examine each dimension. RESULTS: The median EQ-5D Index and VAS scores were 0.65 (0.5-0.75) and 80 (60-90), respectively. The most frequently reported problem was anxiety/depression (67.3%), followed by usual activities (48.6%). The statistical analysis showed that factors significantly associated with more reported problems in at least one EQ-5D dimension (P < .05) were: females, ageing, being unmarried, low income, school studies, living in refugee camps, and villages, unemployment, having chronic diseases or pain, and obesity. It is important to note that participants who responded in November showed more problems compared with December 2020. On the other hand, more problems were reported by participants who were infected, had known affected persons, had no enough information, perceived negative effect of confinement, and indicated having a high infection chance (P < .05). CONCLUSIONS: This work provides important evidence on the health status and wellbeing during the COVID-19 confinement in a sample of the Palestinian population, affecting almost all the aspects of the health state and wellbeing. This effect could be minimised by improving the COVID-19 preventive education and monitoring that can play an important role in all health and life aspects among the Palestinian population in facing this pandemic.

The Relationships Among the Organizational Factors of a Tertiary Healthcare Center for Type 2 Diabetic Patients in Palestine.

BACKGROUND: Diabetes prevalence at Palestine was 10%, with a rising fund crisis, and diabetes healthcare problems. There was a limited research concerning diabetes healthcare dimensions including organizational factors and their predictors. OBJECTIVE: This study described patient characteristics and organizational factors, and assessed relationships among organizational factors of type 2 diabetes health care in Palestine. METHODS: This study is a retrospective cross sectional study, recruited by convenience sampling method in 330 participants from a type 2 diabetes patients list. It was carried out at Ramallah, Palestine. The Statistical Package for Social Sciences (SPSS v 19) was used to analyze data on patient characteristics and organizational factors collected from personal interview and medical records review. RESULTS: The results showed that 51.2% were males, and 88.5% had additional chronic diseases. Preventive healthcare and patient-healthcare professionals' relationship were the most prominent organizational factors in statistically significant relationships among organizational factors. CONCLUSION: This study reflected the need for reviewing prescription mode, and educational programs that emphasize the diabetes self-care management and the health care providers' role that would be of great benefit in health outcomes further.

Knowledge And Attitudes Of Pharmacy Students Towards Pharmacogenomics Among Universities In Jordan And West Bank Of Palestine.

BACKGROUND: Testing by pharmacogenomics (PGx) aims to reduce the side-effects of medicines and to optimize therapy. AIM: To ascertain the knowledge and attitudes towards PGx among pharmacy students in Jordan and West Bank of Palestine (WBP). METHODS: This cross-sectional study focused on pharmacy students from five universities in Jordan and WBP. Students were asked to answer an online survey comprising 30-closed ended questions measuring the knowledge and attitudes towards PGx. RESULTS: The total number of respondents to the questionnaire was 466. Most (96.1%) respondents knew that genetic variations can affect the drug response. Most students stated that the total number of lectures mentioning PGx was fewer than three. Most (>80%) respondents answered that they knew that human genetics can affect the response, inter-individual variation, and ethnic variations in the drug response. However, their knowledge about US Food and Drug Administration recommendations regarding PGx testing of commonly used drugs was weak. Also, 60.3% of respondents stated that the information they received about PGx was insufficient. Most (>92.7%) students wished to know more about PGx and believed that PGx is helpful in choosing the appropriate drug. CONCLUSION: Pharmacy students had fair knowledge and good attitudes towards PGx. These factors could aid application of PGx in clinical practice in Jordan and WBP.