Epidemiology of overweight and obesity in early childhood in the Gulf Cooperation Council countries:a systematic review and meta-analysis protocol

Introduction There has been a notable increase in the prevalence of overweight and obesity in school-aged children in many industrialised regions. The worldwide prevalence of childhood overweight and obesity increased from 4.2% in 1990 to 6.7% in 2010. Although many studies have been published, the epidemiological burden of overweight and obesity in the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates) is unclear. There is a need to bring together and appraise relevant studies in order to estimate the epidemiological burden (including incidence, prevalence, risk factors, trend over time) of overweight and obesity in this region and thus help to inform national and regional policies. Methods and analysis We will conduct a systematic review and meta-analysis on the epidemiology of overweight and obesity in early childhood including incidence, prevalence, risk factors and trends over time in the GCC countries. We will search international electronic databases including MEDLINE, EMBASE, Cochrane Library, ISI Web of Science, CINAHL, Google Scholar, AMED, Psych INFO, CAB International and WHO Global Health Library for published, unpublished and in-progress epidemiological studies of interest published from inception to 2017. In addition, we will contact an international panel of experts on the topic. There will be no restriction on the language of publication of studies. We will use the Effective Public Health Practice Project (EPHPP) to appraise the methodological quality of included studies. Meta-analysis will be undertaken using random effects models. Ethics and dissemination Ethical approval is not required. The outcome of the review will be disseminated through conference presentations and peer-reviewed journal publication

Prevalence of Allergic Disorders among Primary School-Aged Children in Madinah, Saudi Arabia: Two-Stage Cross-Sectional Survey

There are limited data on the epidemiology of allergic disorders in Saudi Arabia. Such data are needed for, amongst other things, helping to plan service provision at a time when there is considerable investment taking place in national healthcare development. We sought to estimate the prevalence of atopic eczema, allergic rhinitis and asthma in primary school children in Madinah, Saudi Arabia.We conducted a two-stage cross-sectional survey of schoolchildren in Madinah. Children were recruited from 38 randomly selected schools. Questionnaires were sent to the parents of all 6,139 6-8 year old children in these schools. These parental-completed questionnaires incorporated questions from the International Study of Asthma and Allergies in Childhood (ISAAC), which had previously been validated for use in Arab populations. We undertook descriptive analyses, using the Generalized Estimating Equation (GEE) to calculate 95% confidence intervals. The overall response rate was 85.9% (n = 5,188), 84.6% for girls and 86.2% for boys, respectively. Overall, parents reported symptoms suggestive of a history of eczema in 10.3% (95%CI 9.4, 11.4), rhinitis in 24.2% (95%CI 22.3, 26.2) and asthma in 23.6% (95%CI 21.3, 26.0) of children. Overall, 41.7% (95%CI 39.1, 44.4) of children had symptoms suggestive of at least one allergic disorder, with a substantial minority manifesting symptoms indicative of co-morbid allergic disease. Comparison of these symptom-based prevalence estimates with reports of clinician-diagnosed disease suggested that the majority of children with eczema and asthma had been diagnosed, but only a minority (17.4%) of children had been diagnosed with rhinitis. International comparisons indicated that children in Madinah have amongst the highest prevalence of allergic problems in the world.Symptoms indicative of allergic disease are very common in primary school-aged children in Madinah, Saudi Arabia, with figures comparable to the highest risk regions in the world

Investigating the association between obesity and asthma among primary schoolchildren in Madinah, Saudi Arabia

Background: Over the latter half of the last century, a dramatic increase in the prevalence of asthma has been observed. Over this same period there has been a substantial increase in the prevalence of obesity, this giving credence to the hypothesis that obesity and asthma may be causally associated. Aim: The main aims of this thesis were to: i) estimate the prevalence of asthma, allergic rhinitis, and atopic eczema in primary schoolchildren in Madinah, Saudi Arabia; ii) investigate the association between childhood obesity and prevalence of asthma; and iii) investigate possible mechanisms that might explain any associations observed. Methods: I undertook a pilot study aimed at testing the feasibility of conducting a large-scale descriptive epidemiological study of asthma and associated allergic disorders. This was followed by a two-stage cross-sectional survey, which was conducted to investigate the prevalence of asthma, allergic rhinitis, and atopic eczema in a sample of 5,188 schoolchildren, aged 6-8 years using an Arabic, validated version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Finally, I undertook an analytical study investigating the relationship between obesity and asthma. The cross-sectional study allowed for the identification of cases (i.e. those with a history of symptoms suggestive of asthma) and controls (i.e. those without a history suggestive of asthma). A sample of 632 cases and controls were recruited into a matched case-control study. Conditional logistic regression analysis, with appropriate adjustment for a range of potential confounders, was undertaken to explore the association between measures of obesity (in particular, body mass index (BMI)) and asthma. The possible aetiological roles of atopy and airway obstruction were studied by investigating the impact of sensitisation to common aeroallergens and measurements of lung function on the association between body mass index (BMI) and asthma. Results: In the pilot study, I found that the asthma, allergic rhinitis, and atopic eczema were very prevalent in children in Madinah and that further epidemiological studies were therefore likely to be feasible. The overall prevalence of children with a history of symptoms suggestive of asthma was 23.6% (95% CI: 21.3, 26.0); the prevalence among boys was estimated at 24.4% (95% CI: 22.0, 26.9) and among girls at 21.9% (95% CI: 17.4, 27.1), respectively. After adjustment for a number of possible confounders, BMI was found to be a significant predictor of the odds of asthma in both boys (OR=1.11; 95% CI: 1.03, 1.19) and girls (OR=1.38; 95% CI: 1.23, 1.56). When sensitisation to allergens was included in the analyses, the effect of BMI on the risk of asthma was no longer evident in boys (OR=1.09, 95% CI: 0.99-1.19) or girls (OR=1.25; 95% CI: 0.96-1.60). When the effect of lung function measures were factored into the model, the association however persisted: boys: OR=1.10 (95% CI: 1.02, 1.18) and girls OR=1.37 (95% CI: 1.22, 1.54). Conclusions: Asthma and related allergic disorders are very common in primary schoolchildren in Saudi Arabia. BMI is associated with symptoms suggestive of asthma in primary schoolchildren. This effect does not appear to be mediated through respiratory obstruction, but may, at least in part, be mediated through increasing the risk of allergic sensitisation. Prospective and more detailed gender-specific mechanistic studies are now needed to further investigate this association

al Maraji' Ilmu al Sukun al Handasi

549 hal.; 24 C

Evaluate the Toxicity of Pyrethroid Insecticide Cypermethrin before and after Biodegradation by Lysinibacillus cresolivuorans Strain HIS7

Herein, bacterial isolate HIS7 was obtained from contaminated soil and exhibited high efficacy to degrade pyrethroid insecticide cypermethrin. The HIS7 isolate was identified as Lysinibacillus cresolivuorans based on its morphology and physiology characteristics as well as sequencing of 16S rRNA. The biodegradation percentages of 2500 ppm cypermethrin increased from 57.7% to 86.9% after optimizing the environmental factors at incubation condition (static), incubation period (8-days), temperature (35 °C), pH (7), inoculum volume (3%), and the addition of extra-carbon (glucose) and nitrogen source (NH4Cl2). In soil, L. cresolivuorans HIS7 exhibited a high potential to degrade cypermethrin, where the degradation percentage increased from 54.7 to 93.1% after 7 to 42 days, respectively. The qualitative analysis showed that the bacterial degradation of cypermethrin in the soil was time-dependent. The High-Performance Liquid Chromatography (HPLC) analysis of the soil extract showed one peak for control at retention time (R.T.) of 3.460 min and appeared three peaks after bacterial degradation at retention time (R.T.) of 2.510, 2.878, and 3.230 min. The Gas chromatography–mass spectrometry (GC–MS) analysis confirmed the successful degradation of cypermethrin by L. cresolivuorans in the soil. The toxicity of biodegraded products was assessed on the growth performance of Zea mays using seed germination and greenhouse experiment and in vitro cytotoxic effect against normal Vero cells. Data showed the toxicity of biodegraded products was noticeably decreased as compared with that of cypermethrin before degradation

Polymeric Matrix System for Prolonged Delivery of Tramadol Hydrochloride, Part II: Biological Evaluation

This study is an extrapolation of our previous one (part I) concerned with the formulation and physicochemical evaluation of a novel, simple, monolayer, easy-to-use, cost-effective, and aesthetically acceptable bioadhesive transdermal patch for tramadol hydrochloride. The current work is focused on bioadhesion, skin tolerability, and pharmacodynamic evaluation. Using naked rat skin, chitosan–Eudragit® NE30D (1:1) film attained best bioadhesive properties. During in vivo studies, it also showed a significantly extended analgesic effect compared to both oral formula and chitosan single polymeric film using the hot plate test method. All the polymeric films were skin tolerable for the intended period of application according to the Draize test. The success of our approach can proudly, positively contribute into the world of pain management and arguably push transdermal delivery to realize its great promise

An Update on Drug-Induced Pigmentation

Drug-induced pigmentation accounts for up to 20% of all cases of acquired pigmentation. A thorough review of medical history and previous and ongoing medications as well as a complete skin examination can guide diagnosis. Implicated agents include alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents, among others. Confirming true drug associations can be challenging, especially in the setting of delayed onset of pigmentation and coexisting polypharmacy