Short-term outcomes of laparoscopic sleeve gastrectomy among obesity patients in the northern west bank: a retrospective records review

BACKGROUND: Conservative methods for weight loss are usually disappointing. Therefore, surgeries such as Laparoscopic Sleeve Gastrectomy (LSG) should be considered. We aimed to evaluate the outcomes (body mass index; BMI) of LSG among obesity patients in the Northern West Bank. METHODS: Hospital records were reviewed for all patients who had undergone LSG since 2010 in Arab specialized hospital in Nablus and Palestinian Red Crescent society hospital in Tulkarem. Then, patients have been invited again to participate in the study and asked to self-report further pre-/post-operative measures. The primary study outcome was the change in BMI while secondary outcomes included obesity associated co-morbidities’ measures; hypertension (HTN) and diabetes mellitus (DM). RESULTS: The mean age (standard deviation; SD) of the study participants (n = 30; 20 women and 10 men) was 34.06 (10.71) years. The mean (SD) follow-up time was 7.16 (5.05) months. The mean ± SD of the pre-operative BMI was 47.23 ± 7.89 kg/m(2) while 36.74 ± 7.74 kg/m(2) post-operatively (95% CI for mean differences and P-value; 8.83-12.14 and 0.001). For the clinically diagnosed hypertensive patients, there was a mean (SD) reduction of 27.50 (9.87) mm Hg in systolic pressure (P < 0.026) and 18.33 (13.66) of the diastolic blood pressure (P < 0.042). For diabetics, there were clinically and biologically clear mean (SD) reductions in fasting blood sugar and glycated hemoglobin A1c of about 82.00 (22.70) mg/dl and 1.90 (0.78) %; respectively. Only practicing sports or exercise (no/yes) remained significant with post-operative BMI (regression coefficient B = −7.33; P-value and 95% CI for B; 0.009 and −12.68- -1.98). CONCLUSIONS: LSG can significantly improve BMI and could improve or resolve obesity associated co-morbidities like HTN and DM. LSG could be recommended for co-morbid obesity patients who fail to reach beneficial results from a structured weight loss programs

Evaluation of hypertension knowledge among hypertensive and non-hypertensive adults: a crosssectional study from Palestine

Hypertension is one of the leading causes of morbidity and mortality worldwide and significantly contributes to the burden of non-communicable diseases especially in low and middle income countries like Palestine. The current study aimed to evaluate the level of knowledge on hypertension among the Palestinian hypertensive and non-hypertensive adults in the West Bank. The study was conducted in a cross-sectional design in Hebron, Ramallah, Nablus, and Tulkarm directorates in the West Bank. Convenient proportional sample from each directorate was selected with a total of 1200 subjects from all directorates. The participants were interviewed face to face for data collection using a previously validated hypertension knowledge level scale questionnaire (HK-LS) that included (among others) selfreported lifestyle, medication and clinical history questions. The questionnaire had 22 questions where a new continuous variable (score) was developed ranged from 0-22. In our study, the participants had an adequate level of knowledge regarding hypertension and they showed a good understanding of the main concepts (definition, medical treatment, lifestyle, diet, complications). The mean score for hypertensive and non-hypertensive participants were 18.22 and 16.74 respectively. This indicates that those with hypertension have superior knowledge amongst the two groups. Hypertensive participants’ results were related to some socio-demographic factors including city, age, educational level, and physician visit. On the other hand, non-hypertensive participants’ scores were associated with age, gender, marital status, smoking status, educational level, and physician visit. Knowledge of hypertension among the general population was acceptable and those with hypertension showed a higher level of knowledge in comparison to those without hypertension. There should be more focus on educational programs that help improve the knowledge about hypertension in the general population. There should also be an emphasis on the importance of the physicians’ role in the awareness and education of the patients.ACKNOWLEDGEMENTS The authors would like to thank all participants in this study for their cooperation and understanding. Funding Non

Vision-related quality of life among patients with keratoconus: a cross sectional study

PurposeThe present study aimed to evaluate the quality of life of keratoconus patients residing in Nablus city, Palestine. Furthermore, we investigated the possible correlation between Pentacam topographic indices and the quality of life of patients with keratoconus.MethodsThis cross-sectional study evaluated keratoconus patients at An-Najah University Hospital in 2019, diagnosed through clinical examination and corneal tomography. A control group was randomly selected from non-keratoconus patients with normal tomography. The NEI-VFQ-25 questionnaire was administered during face-to-face interviews to compare both groups. NEI-VFQ-25 assesses vision-related quality of life and is a validated tool.ResultsKeratoconus patients’ quality of life is significantly impacted, mainly in near and distant vision, general vision, mental health, and social health, but not in general health, ocular pain, color vision, role difficulties, or dependency. Visual acuity is significantly affected in both eyes of keratoconus patients.ConclusionPatients with keratoconus exhibit a decreased quality of life related to vision, with physical, emotional, and social impairments demonstrated by the NEI-VFQ-25 when compared to controls. Since keratoconus patients are typically young adults in their productive years, understanding their concerns about their future is an important public health aspect that can aid in modifying their treatments. By addressing the specific needs of this patient population, healthcare providers can better support their long-term well-being and quality of life

Interventional cardiac catheterization predictors at Al-Arabi heart Center in Palestine in 2017

Cardiac catheterization is performed for both therapeutic and diagnostic reasons, in which the outcome may vary from only medical treatment to the need of percutaneous coronary intervention and ending with coronary artery bypass graft. The primary goal of this study was to determine predictors of revascularization.; A retrospective cohort study was conducted on data collected from records of patients who underwent cardiac catheterization at Al-Arabi Heart Center in Palestine in 2017. Multivariate logistic regression analysis was carried out to assess the association of sociodemographic and pre-catheterization clinical predictors with revascularization.; A total of 1550 patients were included in the study. The participants mean age was 58 with a SD of 11.7 years, 73.6% were males. 50.2% of patients who underwent an interventional cardiac catheterization tested negative for troponin on presentation. Multivariate logistic regression showed Troponin (RR = 4.5), Age (RR = 1.0), Female gender (RR = 0.4) previous catheterization (RR = 2.0), and existence of diabetes as significant predictors for revascularization. The correlation between ECG on presentation and the subsequent need for an interventional cardiac catheterization was significant only in case of ST-Elevation (RR = 1.5), and T wave inversion (RR = 1.6). CK-MB, Hypertension and ECG with ST-depression were not significant predictors.; This study assessed revascularization predictors in addition to characteristics and outcomes of patients who have undergone cardiac catheterization. The results showed the especially high predictive value of troponin in determining the need for revascularization which outweighed the importance of ECG findings on presentation in making clinical decision regarding catheterization

Exposure assessment of radon in the drinking water supplies: a descriptive study in Palestine

<p>Abstract</p> <p>Background</p> <p>Radon gas is considered as a main risk factor for lung cancer and found naturally in rock, soil, and water. The objective of this study was to determine the radon level in the drinking water sources in Nablus city in order to set up a sound policy on water management in Palestine.</p> <p>Methods</p> <p>This was a descriptive study carried out in two phases with a random sampling technique in the second phase. Primarily, samples were taken from 4 wells and 5 springs that supplied Nablus city residents. For each source, 3 samples were taken and each was analyzed in 4 cycles by RAD 7 device manufactured by Durridge Company. Secondly, from the seven regions of the Nablus city, three samples were taken from the residential tap water of each region. Regarding the old city, ten samples were taken. Finally, the mean radon concentration value for each source was calculated.</p> <p>Results</p> <p>The mean (range) concentration of radon in the main sources were 6.9 (1.5-23.4) Becquerel/liter (Bq/L). Separately, springs and wells' means were 4.6 Bq/L and 9.5 Bq/L; respectively. For the residential tap water in the 7 regions, the results of the mean (range) concentration values were found to be 1.0 (0.9-1.3) Bq/L. For the old city, the mean (range) concentration values were 2.3 (0.9-3.9) Bq/L.</p> <p>Conclusions</p> <p>Except for Al-Badan well, radon concentrations in the wells and springs were below the United State Environmental Protection Agency maximum contaminated level (U.S EPA MCL). The level was much lower for tap water. Although the concentration of radon in the tap water of old city were below the MCL, it was higher than other regions in the city. Preventive measures and population awareness on radon's exposure are recommended.</p

Biomonitoring of complex occupational exposures to carcinogens: The case of sewage workers in Paris

<p>Abstract</p> <p>Background</p> <p>Sewage workers provide an essential service in the protection of public and environmental health. However, they are exposed to varied mixtures of chemicals; some are known or suspected to be genotoxics or carcinogens. Thus, trying to relate adverse outcomes to single toxicant is inappropriate. We aim to investigate if sewage workers are at increased carcinogenic risk as evaluated by biomarkers of exposure and early biological effects.</p> <p>Methods/design</p> <p>This cross sectional study will compare exposed sewage workers to non-exposed office workers. Both are voluntaries from Paris municipality, males, aged (20–60) years, non-smokers since at least six months, with no history of chronic or recent illness, and have similar socioeconomic status. After at least 3 days of consecutive work, blood sample and a 24-hour urine will be collected. A caffeine test will be performed, by administering coffee and collecting urines three hours after. Subjects will fill in self-administered questionnaires; one covering the professional and lifestyle habits while the a second one is alimentary. The blood sample will be used to assess DNA adducts in peripheral lymphocytes. The 24-hour urine to assess urinary 8-oxo-7, 8-dihydro-2'-deoxy-Guanosine (8-oxo-dG), and the in vitro genotoxicity tests (comet and micronucleus) using HeLa S3 or HepG2 cells. In parallel, occupational air sampling will be conducted for some Polycyclic Aromatic Hydrocarbons and Volatile Organic Compounds. A weekly sampling chronology at the offices of occupational medicine in Paris city during the regular medical visits will be followed. This protocol has been accepted by the French Est III Ethical Comitee with the number 2007-A00685-48.</p> <p>Discussion</p> <p>Biomarkers of exposure and of early biological effects may help overcome the limitations of environmental exposure assessment in very complex occupational or environmental settings.</p

Self-filling of male urethra with silicon jell to achieve erection: A case report

Self-insertion of foreign body into male urethra represents heterogeneous group of cases in terms of causes, symptoms and management. We reported a case of 60-year old male patient filled his urethra with silicone-jell. Patient had severe penile pain and difficult urination. Physical examination revealed palpable hard mass starting from distal part of prostatic urethra to midpenile urethra. Rigid cystoscopy showed complete occlusion of urethra. Laser fragmentation and mechanic extraction failed. Open surgery was decided. Midline incision was performed at the distal end of foreign body in the penile urethra. The foreign material was extracted successfully

Environmental exposure assessment of cadmium, lead, copper and zinc in different Palestinian canned foods

Abstract Background Many chemical elements that present in the human diet are essential for human life at low concentrations but can be toxic at high concentrations and chronic exposure. We aimed to assess the levels of some heavy metals in canned food that are sold in the Palestinian market and compare them with the recommended international limits. Methods A total of sixteen canned food samples were collected. The samples included four different manufactures for each of beans, chickpeas, corn and mushroom. After homogenization and samples treatment, the concentrations were determined using flame atomic absorption spectrometer IcE-3000 SERIES. Results The concentrations were found to be in the range of 0.089–1.17 mg/L for Pb, 0.019–0.32 mg/L for Cd, 2.05–10.6 mg/L for Zn and 0.79–3.97 mg/L for Cu. Cadmium and copper results were higher than the maximum permissible limit (0.006 and 0.9 mg/L, respectively), whereas lead (except for only one sample: marina corn) and zinc levels were within the maximum permissible limits (1 and 11 mg/L, respectively). Conclusions The results necessitate continuous monitoring of Cd and Cu levels and controlling of canning process to obtain food safety. As an important environmental health concern, we recommend future human biomonitoring studies to correlate environmental exposure of these elements to biological markers

Clinical and Molecular Characteristics of Diabetic Retinopathy and Its Severity Complications among Diabetic Patients: A Multicenter Cross-Sectional Study

Background: Diabetic retinopathy (DR) is a complication associated with uncontrolled DM. It is a leading preventable cause of visual impairment in the world and a cause of blindness in those under 75 years old in developing countries. We aimed to explore the prevalence and associated risk factors of DR among diabetic patients in the West Bank. Materials and Methods:A quantitative multicenter cross-sectional study was conducted in all West Bank cities. Nearly, 385 patients underwent a comprehensive eye examination in addition to blood and urine tests. A previously validated questionnaire for ocular examination classification was used together with a socio-demographic and past medical history information sheet. Results: The prevalence of all DR in the West Bank was 41.8%. The prevalence of non-proliferative diabetic retinopathy (NPDR) was 50.3% (38.5% for mild NPDR, 10.6% for moderate NPDR and 1.2% for severe NPDR). The prevalence of proliferative diabetic retinopathy (PDR) was 9.9% and 39.7% for diabetic macular edema (DME) (17.4% for mild, 15.5% for moderate and 6.8% for severe DME). The prevalence of vision-threatening PDR and DME was 49.7% for both. In a univariate analysis, DR was significantly associated with body mass index; BMI (p = 0.035), DM duration (p = 0.002), Low-density lipoprotein (LDL) (p = 0.034), glutamic-oxaloacetic transaminase (GOT) level (p = 0.016) andblood urea (BU) (p = 0.044). A multivariate analysis showed a strong significant association between DR andpatients who had DM for 10-19years (adjusted odds ratio; AOR (95%CI); 1.843 (1.05&ndash;3.22)), abnormal levels of LDL (AOR (95%CI); 0.50 (0.30&ndash;0.83)), abnormal levels of GOT (AOR (95%CI); 0.49 (0.27&ndash;0.89)), and overweight (AOR (95%CI); 0.39 (0.19&ndash;0.80)). Conclusions: We found that the prevalence of DR in Palestine was higher than the global prevalence. Referral coordination between ophthalmologists and internal physicians is necessary to better follow up with DR patients. An interventional educational program by clinicians and public health professionals is recommended