Adolescent obesity in Syria: prevalence and associated factors.

Abstract Background Data on the prevalence of overweight and obesity in Eastern Mediterranean countries remain scarce, particularly for children and adolescents. The objective of this study is to estimate the prevalence of obesity and examine associated factors and covariates amongst school adolescents in Syria. Methods A cross-sectional survey of a representative sample of 776 adolescents (386 males and 390 females), aged 15-18 years, was conducted in six randomly chosen secondary schools in Damascus, the capital city of Syria. Anthropometric measurements and dietary assessment data were collected using standard methods and techniques. Overweight and obesity were defined according to World Health Organization 2007 child growth standards. Results The prevalence rates of overweight and obesity were estimated at 18.9 and 8.6%, respectively. Carbohydrate and saturated fatty acid intakes were significantly higher amongst overweight and obese (250.66 and 32.82 g/day, respectively) as compared with normal weight adolescents (218.12 and 26.10 g/day, respectively). Regression analysis showed that the likelihood of obesity was significantly greater amongst adolescent boys than girls (OR = 2.30, P < 0.05) and amongst subjects reporting family history of obesity (OR = 2.98, P < 0.05). The odds of obesity increased consistently with increasing educational attainment of both parents and was higher (OR = 1.63) amongst adolescents reporting lower crowding index than their counterparts. Conclusion Our findings of a positive association between obesity and socio-economic status measured by parental education and crowding index call for intervention strategies for the promotion of healthy dietary practices not only amongst school adolescents but also parents, targeting families as the unit of intervention. Further studies are needed to examine nutritional habits and food choices amongst families of different socio-economic strata.

Clinical characteristics of multiple sclerosis in Lebanon.

The epidemiologic, clinical, radiological and laboratory characterization of multiple sclerosis (MS) is very well documented in Caucasian and Japanese populations, but very little is known about MS in the Arab world. Such knowledge is becoming of paramount importance, with the recent advances in therapies, MRI techniques and other diagnostic procedures. We report a cohort of Lebanese MS patients, including details of their clinical and laboratory characteristics. The medical records of 202 patients fulfilling the Mc Donald's diagnostic criteria, and followed in our tertiary care center were reviewed. This cohort is highly representative of the disease in Lebanon where the number of MS patients is estimated to be between 1200 and 1700. The peak age of onset of MS in our cohort was in the third decade with 62.4% of patients developing their first symptoms between 20 and 39 years. The female/male ratio was 1.8/1.0. A positive family history for MS was present in 5% of patients. The most frequent presenting symptoms were brainstem-cerebellar (46.2%) followed by sensory (42.5%), motor (33.9%) and visual (29.6%). Of the total number of patients, 85.1% had relapsing remitting MS at onset, and 7.9% primary progressive MS. Benign MS defined as EDSS<=2.0 after 10 years from onset was present in 20% of patients. The mean time from onset to secondary progressive MS was around 9 years. Visual, brainstem, and somatosensory evoked potentials were abnormal in 65.6%, 27.8%, and 50.7% of patients tested respectively. Cerebrospinal fluid showed pleocytosis in 32.6%, increased IgG synthesis in 45.2%, positive oligoclonal bands in 40%, and elevated protein in 34% of patients tested. Although some of the clinical characteristics of our MS population were different compared to western series, the natural history of the disease was similar.

Smoking patterns and predictors of smoking cessation in elderly populations in Lebanon.

OBJECTIVE: To investigate smoking patterns in an elderly, low-income population and to identify predictors of smoking cessation, in addition to analyzing the importance of smoking in relation to other risk factors for hospitalization. DESIGN: The data were part of an urban health study conducted among 740 individuals aged > or = 60 years in three suburban communities of low socio-economic status in Beirut, one of them a refugee camp. A detailed interview schedule was administered that included comprehensive social and health information. RESULTS: The overall prevalence of current smokers was 28.1%. Almost half of the group were ever smokers, of whom 44% had quit smoking when they experienced negative health effects. Having at least one chronic illness and having a functional disability significantly increased the odds of smoking cessation. In addition, being a former smoker increased the likelihood of hospital admission. CONCLUSIONS: This study is of particular importance, as it has implications for similar low-income and refugee communities in the region and elsewhere. There is a need for more concerted efforts by public health officials to target elderly individuals as a group for smoking cessation interventions, particularly now that mortality and health benefits have been well documented.

Impairments, disabilities and needs assessment among non-fatal war injuries in south Lebanon, Grapes of Wrath, 1996.

STUDY OBJECTIVE: To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN: Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disabilities, and needs. STUDY POPULATION AND SETTING: War wounded persons in towns and villages in South Lebanon during the attack "Grapes of Wrath" in 1996. RESULTS: The majority of the study population were young and in their productive age, mostly injured in the street or while hiding in open shelters. Around half of the injuries resulted in impairments, but, there were no age, gender or geographical differentials by severity of impairment. Almost one third (29%) of the students enrolled in schools at the time of the injury reported failure to continue their education and 42% of the working members lost their jobs with no potential for 34% of them to resume their former jobs. The impact of the injury on impairments, motor disabilities and physical independence was highest for injuries to the lower limbs (age and sex adjusted risk ratio (RR) 1.62, 95% confidence intervals (CI) 1.25, 2.10; 2.98, 95% CI 2.09, 4.23; and 2.13, 95% CI 1.39, 3.27, respectively). Despite the acute and early relief services provided by all those concerned at the time of the injury, when asked about unmet needs, the majority of the impaired (66%) reported the need for additional services, mostly medical in nature. The degree of disability was a salient factor for the need for rehabilitative services but not for medical services. CONCLUSIONS: The chronic and diverse needs of people with war injuries are often neglected and underestimated by the governmental institutions and relief agencies. Research funds as well as services should be allocated to tackle the long term and continuous health and social needs of those injured and their families.