Human and economic resources for empowerment and pregnancy-related mental health in the Arab Middle East : a systematic review

Purpose: This systematic review synthesizes research on the influence of human and economic resources for women’s empowerment on their pre- and post-natal mental health, understudied in the Arab world. Methods: We include articles using quantitative methods from Pub Med and Web of Science. Two researchers reviewed databases and selected articles, double reviewing five percent of articles designated for inclusion. Twenty-four articles met inclusion criteria. All 24 articles measured depression as an outcome, and three included additional mental health outcomes. Results: Nine of 17 studies found an inverse association between education and depression; two of 12 studies found contradictory associations between employment and depression, and four of six studies found a positive association between financial stress and depression. These results suggest that there is a negative association between education and depression and a positive association between financial stress and depression among women in the Arab world. Firm conclusions warrant caution due to limited studies meeting inclusion criteria and large heterogeneity in mental health scales used, assessment measures, and definitions of human and economic resources for women’s empowerment. Conclusions: It is likely that education reduces depression among post-partum women and that financial stress increases their depression. These findings can be used to aid in the design of interventions to improve mother and child outcomes. However, more research in the Arab world is needed on the relationship between human and economic resources for women’s empowerment and perinatal mental health, and more consistency is needed in how resources and mental health are measured

Challenges that face the establishment of diabetes biobank in Jordan: a qualitative analysis of an online discussion forum

Omar F Khabour,1 Ahmed Abu-Siniyeh1–31Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Medical Laboratory Sciences, Faculty of Science, Al-Balqa’ Applied University, As Salt, Jordan; 3Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Kingdom of Saudi ArabiaIntroduction: Diabetes is common in Jordan with a prevalence of about 13% of the population. Establishment of a diabetes biobank in Jordan could have an enormous impact on the management and prevention of the disease.Methods: In the current study, ethical challenges that might face the establishment of a biobank were examined by 28 researchers from the Middle East and North Africa region using an online discussion forum.Results: All participants agreed on the importance of the establishment of a diabetes biobank in Jordan. The possible challenges that were discussed included confidentiality and privacy, informed consent, specimen ownership and participants’ rights, data sharing, returning of research results and incidental findings, lack of legislations, and importance of social awareness and public engagements with biobanks.Conclusion: In conclusion, participants support the establishment of a diabetes biobank in Jordan; however, some ethical issues should be considered to ensure the success of the biobank.Keywords: diabetes, biobank, Jordan, MENA, ethic

The role of PAX9 promoter gene polymorphisms in causing hypodontia: a study in the Jordanian population

Ahmed Abu-Siniyeh,1 Omar F Khabour,1 Arwa I Owais2 1Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan Background: The congenital absence of one or few teeth, hypodontia, is considered one of the utmost dental ageneses in human beings. Several genes have been shown to be involved in the development of hypodontia such as paired box gene 9 (PAX9). The expression of PAX9 is controlled by several polymorphic elements in the promoter region of the gene on 14q13.3 locus. The aim of this study was to find any association between PAX9 c.-912T>C (rs2073247) and c.-1031G>A (rs2073244) promoter polymorphisms and the development of hypodontia among the Jordanian population. Methods: Genotyping of the polymorphisms in 72 unrelated subjects with hypodontia was performed using PCR-restriction fragment length polymorphism (RFLP) technique and compared with that of 72 normal healthy unrelated control individuals. Results: The hypodontia group had a significantly higher -1031GG genotype (P<0.01) and a significantly lower -912TC genotype (P<0.01) compared with the control group. The results suggest that the transcriptional activity of PAX9 gene is affected by polymorphisms in the promoter region of this gene and is associated with hypodontia phenotype. Conclusion: The rs2073247) and rs2073244 promoter polymorphisms of PAX9 might play a role in the development of hypodontia in the Jordanian population. Keywords: PAX9, hypodontia, Jordan, polymorphism, promote

Considerations and beliefs in tooth donation to research in Jordan

Noor Al Mortadi,1 Omar F Khabour,2 Karem H Alzoubi3 1Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Applied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Background: Research that involves dental pulp stem cells (DPSCs) is growing rapidly. DPSCs can be used for the treatment of craniofacial bone abnormalities and tooth repair. The procedure requires a donation of sound teeth, which might be associated with ethical and moral issues. The purpose of this study was to understand the attitudes and awareness of patients with respect to the donation of their teeth to research. Patients and methods: This study involved 500 patients recruited from Dental Care and Dental Teaching Center in Irbid during May 2017–July 2017. Results: A well-structured questionnaire was administered and prepared using Google forms and filled out using a tablet device. The majority of patients (62.8%) were willing to donate their teeth to research with significant association with educational level. Half of the patients considered that the donated tooth belongs to them even after extraction, whereas 19% believed that the researcher owns it after donation. Almost half (53.6%) of the participants wished to be informed about the type of scientific research that will be carried out on their teeth. The majority (66.5%) preferred to sign a consent document on tooth donation to research during the consultation visit before extraction. Finally, about 61% were worried that their tooth might be extracted for research purposes rather than medical purposes. Conclusion: A good fraction of Jordanian is willing to donate their teeth to research. Educational programs are demanded to enhance the awareness and attitudes of patients on the ownership of extracted teeth, consent process, and donation of teeth. Keywords: stem cells, attitude toward ethical concerns, medical ethics, knowledge of ethical concerns, patient right, tooth donation, consent for

Perspectives and attitudes of Jordanian medical and paramedical students toward surrogate pregnancy

Ayman G Mustafa,1,2 Karem H Alzoubi,3 Omar F Khabour,4 Mahmoud A Alfaqih2 1College of Medicine, Qatar University, Doha, Qatar; 2Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; 3Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan; 4Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan Purpose: This study aims at investigating the perspectives of Jordanian medical and paramedical students on surrogate pregnancy. Methods: A questionnaire-based cross-sectional study design was used. The sample consisted of n=328 students of both genders. The questionnaire responses were numerically coded and analyzed across gender and the level of education. Results: Approximately, 18% of the students reported good awareness about the ethical dilemmas of surrogacy. The results showed a general reluctance to accept surrogate pregnancy as the majority (80.5% of male students and 97.6% of female students) had a negative attitude toward surrogacy. In addition, undergraduate students were less supportive to surrogate pregnancy than graduate students. Religious considerations were the main reason (accounts for about 70%) for driving negative attitude toward surrogacy. Conclusion: The findings of the study indicate a general reluctance toward accepting the concept of surrogate pregnancy, which is mainly due to religious reasons. Keywords: perspectives, attitudes, medical, students, paramedical, surrogate pregnanc

Public attitudes toward corneal donation in northern Jordan

Mera F Haddad,1 Omar F Khabour,1 Karem H Alzoubi,2 May M Bakkar1 1Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Purpose: The aims of this study were to assess the knowledge and attitude toward corneal donation among Jordanian population and to report the reasons which may influence subject’s decision and attitude toward corneal donation.Methods: A self-designed questionnaire was developed. The participants were asked about reasons for both willingness and unwillingness to donate their corneas. These reasons were stated in the questionnaire and the participants had to express their agreement by one of five options: strongly disagree, disagree, neutral, agree, or strongly agree.Results: A total of 500 participants (218 males and 282 females) completed the questionnaire. The average age (±SD) of the study participants was 32.8 (±11.7) years. About 67.2% of the subjects were willing to donate their corneas, whereas 32.8% were not willing to do so. The main motive for willingness was doing a good deed by helping others to see. On the other hand, fear of the body being treated badly and that other organ might be taken than the ones specified for donation were the main reasons for unwillingness to donate corneas. The age of participants, gender, and the monthly income did not significantly influence the willingness to donate (P>0.05). However, the level of education had a significant influence on people’s decision to donate their corneas.Conclusion: Many Jordanians have positive attitude toward corneal donations. Ethical factors need to be addressed to promote for corneal donation. In addition, increasing the awareness of donation and its benefits may help increase the supply of corneal tissues. Keywords: corneal donation, willingness, Jorda

Serum trace elements in insulin-dependent and non-insulin-dependent diabetes: a comparative study

Ahmed M Ahmed,1 Omar F Khabour,1,2 Akram H Awadalla,3 Hisham A Waggiallah4 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia; 2Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Chemistry, College of Medical Laboratory Sciences, Kordofan University, Alobayid, Sudan; 4Department of Medical Laboratory Sciences, Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia Background: Diabetes mellitus is associated with imbalance in body trace elements. The aim of the current investigation was to compare the levels of trace elements (Zn, Mg, Mn, Cu, Na, K, Fe, Ca, Cr, and Se) in insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetes. Methods: A total of 100 patients with diabetes (40 IDDM and 60 NIDDM) and 50 healthy subjects were recruited in the study from both genders. Biochemical measures include glucose, lipids, and HbA1C. Results: The results showed that Zn, Mg, Cu and Cr were significant lower in patients with diabetes compared to the control group (P<0.01). In addition, Zn and Cr were significantly lower in IDDM than NIDDM (P<0.05). Moreover, Zn and Mg levels were inversely correlated with HbA1c in IDDM and NIDDM (P<0.05). Zn was inversely correlated with fasting blood glucose in IDDM (P<0.05). Finally, no correlation between trace element levels with BMI was found (P>0.05). Conclusion: Disturbance in trace element profile among IDDM and NIDDM is similar. Keywords: trace elements, diabetes mellitus, IDDM, NIDD

Association between leptin gene rs7799039 polymorphism and lipid profile changes induced by isotretinoin treatment in acne patients

Omar F Khabour,1,2 Karem H Alzoubi,3 Abdul Samad Firoz,1,4 Rafat MM Al-Awad2 1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia; 2Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 4Center for Genetics and Inherited Diseases, Faculty of Medicine, Tabiah University, Madinah, Saudi Arabia Introduction: Isotretinoin, a vitamin A-derived medication, is one of the effective treatments for severe acne. However, in a fraction of patients, this treatment causes significant adverse effects. Leptin is a pro-inflammatory cytokine that plays a role in apoptosis of adipose cells and sebaceous lipid metabolism. Thus, genetic polymorphisms in the leptin (LEP) gene may modulate the response to isotretinoin therapy. Here, we explore the contribution of rs7799039 polymorphism of the LEP gene in the adverse effects of the oral isotretinoin therapy among acne patients. Materials and methods: Clinical parameters were obtained from 200 patients before and after isotretinoin treatment for acne. In addition, circulatory lipid profile and aspartate transaminase (AST) and alanine aminotransferase (ALT) enzymes from acne subjects before and 1 month after oral isotretinoin treatment were also measured. Results: An association between the rs7799039 polymorphism and the following lipid parameters: high-density lipoprotein (HDL) at baseline and after treatment, HDL % change, low-density lipoprotein % change and total cholesterol % change (P < 0.05). In addition, there was an association between the LEP polymorphism and higher AST and ALT at baseline and after treatment (P < 0.05). Conclusion: In conclusion, rs7799039 LEP polymorphism might modulate lipid parameters and liver enzymes, but not other major side effects of oral isotretinoin therapy. Keywords: leptin, isotretinoin, acne, polymorphism, side effect