Dietary polyphenols and the risk of metabolic syndrome: a systematic review and meta-analysis.

BACKGROUND: Accumulating evidence has suggested that dietary polyphenols may be protective against metabolic syndrome (MetS); however, the available evidence is contradictory. The aim of this meta-analysis was to assess the association between dietary intake of polyphenols and the odds of MetS. METHODS: The PubMed and Scopus databases were systematically searched to obtain eligible studies. The risk of MetS for the highest versus the lowest intakes of total, subclasses and individual polyphenols were examined by pooling odds ratios (OR) and 95% confidence intervals (95%CI) using the random effects model. RESULTS: A total of 14 studies (6 cohort and 8 cross-sectional studies) involving a total of 50,366 participants with 10,879 cases of MetS were included. When various polyphenol compounds were pooled, they were significantly related to a 22% decreased odds of MetS (([5 studies]; OR: 0.78; 95%CI: 0.72-0.85). Higher intakes of total flavonoids (([9 studies]; OR: 0.78; 95%CI: 0.72-0.85), flavan-3-ols (([2 studies]; OR: 0.64; 95%CI: 0.43-0.94), isoflavones (([3 studies]; OR: 0.84; 95%CI: 0.75-0.93), stilbenes (([4 studies]; OR: 0.86; 95%CI: 0.76-0.97), flavones (([2 studies]; OR: 0.79; 95%CI: 0.71-0.89), and quercetin (([2 studies]; OR: 0.63; 95%CI: 0.43-0.93) were also significantly associated with a decreased risk of MetS. The associations were not modified by the age of the participants. No association was found for total polyphenols, phenolic acids, lignans, anthocyanins, and flavonols. CONCLUSION: The results of this meta-analysis supported that higher polyphenol intake can lower the risk of MetS.

Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents.

BACKGROUND: Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq. METHODS: A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale. RESULTS: When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit. CONCLUSION: Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.

Community pharmacist-led interventions to improve medication adherence in patients with cardiovascular disease: a systematic review of randomised controlled trials.

OBJECTIVES: Medication adherence in cardiovascular disease (CVD) is reported to be suboptimal. Therefore, an intervention to tackle non-adherence is important. Pharmacists' intervention may have the potential to enhance medication adherence, leading to improvements in clinical outcomes in patients with CVD. This study assesses the impact of a community pharmacist intervention on improving medication adherence and clinical outcomes in patients with CVD. This study also describes the characteristics and actual contents of the interventions. METHODS: Electronic databases (MEDLINE (Ovid), PsycINFO (Ovid), Cochrane library and PubMed Central) were systematically searched for randomised controlled trials (RCTs), assessing the impact of community pharmacists' interventions on medication adherence in patients with CVD. Eligible RCTs were those published in English from database inception to April 2021. A narrative analysis was performed. The RCTs included were assessed using the Cochrane Risk of Bias. This review included eight RCTs. The majority included a multifaceted intervention with medication reviews and adherence counselling. Sample sizes varied from 225 to 1906, and intervention duration ranged from 2 to 12 months. Seven of the RCTs reported that interventions enhanced medication adherence. Five RCTs assessed the effect of the interventions on the clinical outcomes and reported a trend towards improvement in blood pressure and low-density lipoprotein cholesterol level in the intervention arm. Regarding the quality of evidence, most RCTs were classified as poor, due to the high risk of bias or insufficient reporting of information. SUMMARY: Community pharmacist-led interventions show improvements in medication adherence and clinical outcomes, but the content and delivery of the interventions vary. Future research should focus on identifying the most effective components that contribute to enhancing medication adherence and clinical outcomes for patients with CVD.

Exploring the quality of life of cosmetic users: A cross-sectional analysis from eight Arab countries in the Middle East.

BACKGROUND: The use of cosmetic products is growing in dominance in the Arab population, making it essential to measure its effects on users. The production of cosmetics has been largely driven by consumerism and a bid to keep abreast with the latest trends in the beauty industry with less attention on how the users' quality of life (QoL) is affected. AIMS: This study aims to investigate the effect of cosmetic products on users' quality of life in eight Arab countries. METHODS: A cross-sectional study was carried out using an online data collection approach. A validated and specialist instrument tool called BeautyQoL, which consists of five domains and a total of 52 questions, was distributed to a sample of 2219 cosmetic users. Descriptive and inferential statistical analysis was done using SPSS® version 26.0. RESULTS: The mean age of participants was 34 ± 11.25 years, and more women were represented in the sample (71%) than men. The majority of respondents had oily skin type (39.6%) and tan skin tone (30.4%). QoL through cosmetic use is computed with a mean score of 51 out of 100. The users' mean score satisfaction from cosmetic use is centred on attractiveness (56.1), followed by self-confidence (51.8). Cosmetics have a statistically significant effect on participants who are young adults, women, single, and employed with high income. As the respondents' skin tone deepens from very fair to dark, the mean score for each domain significantly increases, whereas when skin type changes from very oily to dry, the mean score for each domain decreases. CONCLUSION: The effect of cosmetics on the users' QoL is limited, contrary to the narrative commonly portrayed in cosmetics' advertisements. Therefore, the use of cosmetics among the Arab population should be from an informed perspective of their specific needs instead of conforming to the viral trends pedaled by influencers and bloggers on social media, which might be irrelevant for them.

Parental health beliefs, intention, and strategies about covid-19 vaccine for their children: A cross-sectional analysis from five Arab countries in the Middle East.

BACKGROUND: The issue around vaccination of children has brought divergent opinions among the populations across the globe and among the Arab population. There has been a low response rate to the calls for vaccination of children and this is reflective of the sentiments which parents may have towards their children being vaccinated. This study aims to explore the parents' health beliefs, intentions, and strategies towards the COVID-19 vaccine for their children among Arab population. METHODS: A cross-sectional study using an online survey from October to December 2021, was carried out in five Arab countries in the Middle East. A reliable health belief model (HBM) including five domains: severity, susceptibility, benefits, barriers and cues to action, was adopted. Chi-square, Mann-Whitney test, and multivariable logistic regression were performed for data analysis. RESULTS: The survey response rate was 58 % (1154/2000). Only 56 % of Arab parents are intended to vaccinate their children against COVID-19. The mean scores of parental health belief are largely driven by their concern over the vaccine's side effect (p = 0.001) followed by its efficacy, safety (p < 0.001), and scheduling difficulty (p = 0.029). However, strategies that were statistically encouraged parents to vaccinate their children included doctor's recommendation, adequate information being provided, and acceptance of the vaccine by public (p < 0.001). Parents with one child were almost three times most likely to vaccinate their children (OR = 2.660, 95 %CI = 1.572-4.504, p < 0.001). Parents' desire to vaccinate their children is also influenced by other factors such as job loss owing to COVID-19 and the presence of a health worker in the family. CONCLUSION: Intention of Arab parents to vaccinate their children via COVID-19 vaccine is still limited. Thus, it is essential for health care authorities to avail the information which will debunk the erroneous beliefs which some parents have developed towards the vaccination of children against COVID-19.

Lockdown Fatigue and University Students: Exploring the Factors That Play Significant Roles in the Level of Lockdown Fatigue Among University Students in the Era of COVID-19.

Background: Due to the COVID-19 global pandemic, the educational sector has undergone a series of changes which have affected both learners and students alike. As a result, the distortion of the students' daily routine, isolation, social distancing and potential exposure to the COVID-19 virus changed almost all of the aspects of student life which has led to exhaustion of students, with both psychological and emotional challenges. Therefore, the main aim of this study is to determine the factors that have a significant impact on the level of lockdown fatigue among university students in the era of COVID-19. Methods: A cross sectional was undertaken for this study. A questionnaire was designed and then shared electronically with the respondents of this study. The respondents were 819 students from tertiary institutions in Iraq. Some of the scales used in ranking the responses of the participants are the Lockdown Fatigue scale, Brief Resilience Scale and Coping Behaviours questionnaire. Data analysis was. Results: Overall, the students had a high level of fatigue due to lockdown-measurement. Emptiness was one of the dominant feelings experienced by the students, along with concern for the safety and well-being of their own families. There was general agreement that students take a long time to return to normal routines after stressful events. The students also indicated that they cope with the lockdown through a variety of activities, ranging from making jokes about the situation to putting their faith in a higher power. Male student were less likely to suffer from lockdown-fatigue, however, studying in public university, being from urban areas, and studying in science field are the most significant factors that increase the level of lockdown. However, lower levels of lockdown fatigue were linked to significantly higher levels of personal resilience and coping abilities. Conclusion: High level of lockdown fatigue among students is noticed, and several factors have been identified. Therefore, it is helpful for students to consistently work on reinforcing positive habits which would help them to build resilience when they are subjected to stressful conditions and scenarios.

Exploring the level of lockdown fatigue and effect of personal resilience and coping behaviours on university students during the covid-19 pandemic: a cross-sectional analysis from Iraq.

Governments worldwide have imposed lockdowns in their countries to restrict unnecessary movement and curb the spread and transmission of the Covid-19 as a mitigation measure. The education sector has also implemented rapid changes, and this has transformed the operational procedures for both students and lecturers. As the pandemic has progressed, its emotional and psychological toll is equally bearing on students, leading to lockdown fatigue. This study aimed to investigate the level of lockdown-induced fatigue and its correlation with personal resilience and coping skills among university students in Iraq. This study used quantitative methods of research using a cross-sectional study design. A questionnaire survey was distributed electronically among 819 university students in Iraq. The study used three standardised scales: the lockdown fatigue scale, brief resilience scale, and coping behaviours questionnaire for data collection. Descriptive and inferential statistical analysis were done using SPSS. Overall, students indicated a high level of lockdown fatigue with a mean score of 33.48out of 50. Fear of personal safety and the wellbeing of the family was the most fear expressed by the students. The ability to go through stressful times and unpleasant events was the most common worry among the students. Female, urbanised, and science field students were the most students who suffered from lockdown-induced fatigue. However, positive coping behaviours and personal resilience were significantly correlated with decreasing fatigue levels during the lockdown period. Level of lockdown fatigue accelerated in an alarming stage among university students in Iraq. Hence, students need to build their emotional resilience and learn how to navigate surviving hard times and bounce back after a loss. This could be facilitated by counselling services being availed to educational and social institutions to benefit university students.

Renal allograft tuberculosis with infected lymphocele transmitted from the donor.

Transmission of tuberculosis (TB) from a donor through renal transplantation is a rare incident. We are reporting a 53-year-old Qatari woman diagnosed with renal allograft TB infection. The disease was confirmed by isolation of Mycobacterium tuberculosis from fluid from the lymphocele and demonstration of caseating granuloma in graft biopsy with acid-fast bacilli seen on Ziehl-Neelsen staining. The diagnosis was made quite early post-transplantation. The presence of the granuloma, which is unusual with patients on intensive immunosuppressant medications, suggests that transmission of the infection occurred from the donor rather than from the activation of latent infection. In reviewing the literature, we found ten case reports of TB in transplanted kidney with transmission of TB infection from the donor. The presence of TB in lymphocele in association with the infected transplant by TB, to the best of our knowledge, was reported only once in the literature. Our case had unfavorable outcome and ended by renal allograft nephrectomy and hemodialysis. We are presenting this case of TB infection of renal allograft and lymphocele diagnosed early post-transplantation transmitted from the donor and pertinent review from the literature.

Safe zone for bone harvesting from the interforaminal region of the mandible.

AIMS: The mandibular incisive nerve can be subjected to iatrogenic injury during bone graft harvesting. Using cone beam computed tomography (CBCT), this study aims to determine a safe zone for bone graft harvesting that avoids injuring this nerve. METHODS: Sixty CBCT examinations of patients were included in this study. The examinations were taken using the i-CAT CBCT imaging system, applying a standardized exposure protocol. Image reconstruction from the raw data was performed using the SimPlant dental implant software. The distances of mandibular incisive canal (MIC) to the inferior border and the labial and lingual cortices of the mandible were measured at 3, 5, 7 and 9 mm mesial to the mental foramen. RESULTS: The MIC was visible in all (100%) CBCT images. The median distance and interquartile range from the lower border of the mandible was 9.86 (2.51) mm, curving downwards toward the inferior mandibular border at the symphysis menti. It was located closer to the buccal border of the mandible (3.15 [1.28] mm) than lingual cortex (4.78 [2.0] mm). The MIC curves toward the lingual side at the symphysis menti. There was gender difference in a number of these measurements. Current recommendation for chin bone graft harvesting can be applied to Asian subjects. CONCLUSIONS: While acknowledging that there is human variability, this study provides an accurate anatomic location of the MIC, which in turn helps to determine a safe zone for chin bone graft harvesting. This information can become a useful guide in centers where CBCT is not available.