Background Metabolic syndrome (MS) is a cluster of
the most dangerous cardiac risk factors and is associated with high mortality.
Ethnic differences in metabolic syndrome (MS) criteria and prevalence rates
have been reported. The purpose of this study was to investigate the MS
prevalence among patients with schizophrenia in Palestine.
Methods We recruited 250 patients with schizophrenia from 4 psychiatric
primary healthcare centers in Northern Palestine. The MS prevalence was
assessed based on National Cholesterol Education Program Adult Treatment Panel
III Adapted criteria.
Results The overall MS prevalence was 43.6%, with 39% in male and 55.9%
in female patients. On average, the study patients had 2.3 ± 1.3 metabolic
abnormalities. Univariate analysis showed that MS was significantly higher with
older age, female gender, longer duration of the illness, smoking, abdominal
obesity, high systolic and diastolic blood pressure, high triglycerides, low
HDL-C, and high fasting plasma glucose. Multiple logistic regression analysis
showed that only systolic blood pressure, high triglycerides, high fasting
plasma glucose, and low HDL-C were significant predictors of MS in
schizophrenic patients.
Conclusions MS is common among Arab patients with schizophrenia.
Patients with schizophrenia should receive regular monitoring and adequate
treatment of cardio-metabolic risk factors.
Aims The main aims of the study were to investigate the
prevalence of pre-diabetes and diabetes mellitus (DM) in patients with
schizophrenia, to compare it with those published in the general
population, and to assess significant associations with dysglycemia
defined as having either pre-DM or DM.
Methods
A cross-sectional study carried out in 4 governmental primary psychiatric healthcare centers in Northern West-Bank, Palestine. Fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were measured. The World Health Organization (WHO) criteria for defining pre-DM and DM were used. Dysglycemia was defined as FBG >110mg/dl.
Results
Based
on WHO criteria, 27 patients (10.8%) had diabetes and 34 (13.6%) had
pre-diabetes. The prevalence of DM in patients with schizophrenia was
not significantly higher than that reported in the general population of
Palestine. However, the prevalence of pre-DM was significantly higher
than that reported in the general population of Palestine. Regression
analysis showed that advancing age and abnormal waist circumference were
significant predictors of dysglycemia in patients with schizophrenia.
Conclusions
This
study confirmed the high prevalence of dysglycemia in patients with
schizophrenia, supporting the need for monitoring of blood glucose in
this category of patients. The presence of primary risk factors is more
important in the development of dysglycemia in patients with
schizophrenia than exposure to antipsychotic drugs.
Background Medical research productivity reflects the level of medical education and practice in a particular country. The objective of this study was to examine the quantity and quality of medical and biomedical research published from Palestine.
Findings Comprehensive review of the literature indexed by Scopus was conducted. Data from Jan 01, 2002 till December 31, 2011 was searched for authors affiliated with Palestine or Palestinian authority. Results were refined to limit the search to medical and biomedical subjects. The quality of publication was assessed using Journal Citation Report. The total number of publications was 2207. A total of 770 publications were in the medical and biomedical subject areas. The annual rate of publication was 0.077 articles per gross domestic product/capita. The 770 publications have an h-index of 32. One hundred and thirty eight (18%) articles were published in 46 journals that were not indexed in the web of knowledge. Twenty two (22/770; 2.9%) articles were published in journals with an IF > 10.
Conclusions The quantity and quality of research originating from Palestinian institutions is promising given the scarce resources of Palestine. However, more effort is needed to bridge the gap in medical research productivity and to promote better health in Palestine.
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.
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.
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.
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.
The agricultural industry is the largest economic sector in Palestine and is characterized by extensive and unregulated use of pesticides. The objective of this study was to analyze phone calls received by the Poison Control and Drug Information Center (PCDIC) in Palestine regarding pesticide poisoning.
All phone calls regarding pesticide poisoning received by the PCDIC from 2006 to 2010 were descriptively analyzed. Statistical Package for Social Sciences (SPSS version 16) was used in statistical analysis and to create figures.
A total of 290 calls regarding pesticide poisoning were received during the study period. Most calls (83.8%) were made by physicians. The average age of reported cases was 19.6 ± 15 years. Pesticide poisoning occurred mostly in males (56.9%). Pesticide poisoning was most common (75, 25.9%) in the age category of 20-29.9 years. The majority (51.7%) of the cases were deliberate self-harm while the remaining was accidental exposure. The majority of phone calls (250, 86.2%) described oral exposure to pesticides. Approximately one third (32.9%) of the cases had symptoms consistent with organophosphate poisoning. Gastric lavage (31.7%) was the major decontamination method used, while charcoal was only utilized in 1.4% of the cases. Follow up was performed in 45.5% of the cases, two patients died after hospital admission while the remaining had positive outcome.
Pesticide poisoning is a major health problem in Palestine, and the PCDIC has a clear mission to help in recommending therapy and gathering information.
In Arab and Muslim-dominated countries, spirituality and religiosity shape the belief and practices toward chronic illnesses. No previous studies were published to assess adherence to and satisfaction with antipsychotic medications in persons with schizophrenia in the Arab world. Objective: To assess medication adherence and treatment satisfaction with antipsychotics in a sample of Palestinian people with schizophrenia. Methodology: Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Psychiatric symptoms were assessed using the expanded Brief Psychiatric Rating Scale (BPRS-E). Data were entered and statistically analyzed using SPSS 16 for windows. Results: A convenience sample of 131 persons with schizophrenia was studied. Based on MMAS-8, 44 persons (33.6%) had a low rate, 58 (44.3%) had a medium rate and 29 (22.1%) had a high rate of adherence. Age was significantly correlated (P=0.028) with adherence score. However, variables like use of monotherapy or atypical or depot antipsychotics were not significantly associated with higher adherence. The means of satisfaction with regard to effectiveness, side effects, convenience and global satisfaction were 72.6 ± 20.5, 67.9 ± 31.47, 63.2 ± 14.3 and 63.1 ± 18.8 respectively. There was a significant difference in the means of effectiveness (P<0.01), convenience (P<0.01), global satisfaction (P<0.01), but not side effects domains (P=0.1) among persons with different levels of adherence. Furthermore, there was a significant difference in the means of positive symptom score (P<0.01), manic (P<0.01) and depression (P<0.01) but not negative symptom score (P=0.4) among persons with different levels of adherence. Conclusions: Medication nonadherence was common and was associated with low treatment satisfaction scores and poor psychiatric scores. Medication related factors had insignificant effects on adherence scores.
Objectives
Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to assess hypoglycemic medication adherence and its association with treatment satisfaction.
Setting
Military Medical Services clinic in Nablus, Palestine.
Methods
This is a cross sectional descriptive study. A convenience sample of 131 diabetic patients was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Questionnaire for Medication were used to assess adherence and treatment satisfaction, respectively. Statistical Package for Social Sciences was used for statistical analysis.
Main
Outcome measure Level of adherence, treatment satisfaction and association between adherence and treatment satisfaction among diabetic patients.
Results
According to MMAS-8, 50 patients (38.5%) had a high adherence, 58 (44.6%) had a medium adherence and 22 (16.9%) had a low adherence rate. The mean scores of satisfaction domains were 71 ± 17.6 and 95 ± 16.4 for effectiveness (EFF) and side effects (SE), respectively. Adherence score was a positively and significantly correlated with EFF satisfaction domain (P < 0.01) and age (P = 0.01). Similar significant correlation was found between adherence level and duration of illness (P = 0.047). However, adherence was not significantly associated with gender (P = 0.2), number of hypoglycemic medications (P = 0.5) or SE satisfaction domain (P = 0.2).
Discussion and conclusion
The majority of diabetic patients in this pilot study were non-adherent. Improving patients' treatment satisfaction will improve treatment adherence.
In Arab and Muslim-dominated countries, spirituality and religiosity shape the belief and practices toward chronic illnesses. No previous studies were published to assess adherence to and satisfaction with antipsychotic medications in persons with schizophrenia in the Arab world. Objective: To assess medication adherence and treatment satisfaction with antipsychotics in a sample of Palestinian people with schizophrenia. Methodology: Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Psychiatric symptoms were assessed using the expanded Brief Psychiatric Rating Scale (BPRS-E). Data were entered and statistically analyzed using SPSS 16 for windows. Results: A convenience sample of 131 persons with schizophrenia was studied. Based on MMAS-8, 44 persons (33.6%) had a low rate, 58 (44.3%) had a medium rate and 29 (22.1%) had a high rate of adherence. Age was significantly correlated (P=0.028) with adherence score. However, variables like use of monotherapy or atypical or depot antipsychotics were not significantly associated with higher adherence. The means of satisfaction with regard to effectiveness, side effects, convenience and global satisfaction were 72.6 ± 20.5, 67.9 ± 31.47, 63.2 ± 14.3 and 63.1 ± 18.8 respectively. There was a significant difference in the means of effectiveness (P<0.01), convenience (P<0.01), global satisfaction (P<0.01), but not side effects domains (P=0.1) among persons with different levels of adherence. Furthermore, there was a significant difference in the means of positive symptom score (P<0.01), manic (P<0.01) and depression (P<0.01) but not negative symptom score (P=0.4) among persons with different levels of adherence. Conclusions: Medication nonadherence was common and was associated with low treatment satisfaction scores and poor psychiatric scores. Medication related factors had insignificant effects on adherence scores.