1
|
Shawahna R, Abdi A, Bani-Odeh D, Saleh R, Owiwi L, Maqboul I, Hijaz H, Jaber M. Breastmilk calcium concentrations in Palestinian lactating women. Acta Paediatr 2024; 113:1315-1321. [PMID: 38482983 DOI: 10.1111/apa.17204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 07/11/2024]
Abstract
AIM Breastmilk calcium concentrations can vary between lactating women and over the lactation period. This study assessed breastmilk calcium concentrations among Palestinian lactating women. METHODS The demographic and dietary variables of the lactating women were collected using a questionnaire. The women provided a sample of about 5 mL of breastmilk using hand expression. Breastmilk calcium concentrations were quantified using an inductively coupled plasma-mass spectrometric method. RESULTS Breastmilk samples were taken from 240 lactating women. The mean breastmilk calcium concentration was 285.4 ± 115.1 mg/L. Lower breastmilk calcium concentrations were associated with age, lactating period, unemployment, dissatisfaction with income and insufficient consumption of vitamins and minerals. CONCLUSION Breastmilk calcium concentrations were affected by demographic variables of the lactating women and insufficient consumption of vitamins and minerals. The findings reported in this study are informative to healthcare providers and decision makers who might be interested in improving the health of lactating women and their infants.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Clinical Research Center, An-Najah National University Hospital, Nablus, Palestine
| | - Aya Abdi
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Diana Bani-Odeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rana Saleh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Lina Owiwi
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Iyad Maqboul
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, Nablus, Palestine
| | - Hatim Hijaz
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, Nablus, Palestine
| | - Mohammad Jaber
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, Nablus, Palestine
| |
Collapse
|
2
|
Shawahna R. Predictors of Breast Milk Zinc Levels Among Breastfeeding Women in Palestine: a Cross-Sectional Study. Biol Trace Elem Res 2022; 200:4632-4640. [PMID: 35767207 DOI: 10.1007/s12011-022-03347-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/24/2022] [Indexed: 11/02/2022]
Abstract
Zinc is one of the most important essential micronutrients that is needed for the normal growth, development, and maintaining the health of human beings. Previous studies showed that zinc deficiency was highly prevalent among pregnant and lactating women. This cross-sectional study was conducted to determine breast milk zinc levels among breastfeeding women in Palestine and to identify the predictors of breast milk zinc levels. Breast milk samples were obtained from breastfeeding women who visited maternity and primary healthcare centers. Zinc levels were determined using inductively coupled plasma mass spectrometry. Breast milk zinc levels were determined in 390 breast milk samples. The mean breast milk zinc level in all samples was 0.15 ± 0.09 mg per 100 mL. Breast milk zinc levels declined with postpartum time from 0.22 ± 0.011 at ≤ 1 month postpartum to 0.09 ± 0.009 mg per 100 mL at > 9 months postpartum (p-value < 0.001). Multiple linear regression showed that high breast milk zinc levels were predicted by younger maternal age, postpartum time, being employed, frequent consumption of multivitamins/minerals, and practicing exclusive breastfeeding. In conclusion, the breast milk zinc levels quantified among breastfeeding women in Palestine were comparable to those previously reported among non-malnourished women elsewhere. The findings of this study are informative to pediatricians, gynecologists, nurses/midwives, breastfeeding advisors/counselors, nutritionists, and policymakers who might be interested in designing and implementing interventions to improve breast milk zinc levels.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Faculty of Medicine and Health Sciences, Department of Physiology, Pharmacology and Toxicology, An-Najah National University, New Campus, Building: 19, Office: 1340, P.O. Box 7, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| |
Collapse
|
3
|
Shawahna R, Zyoud A, Naseef O, Muwafi K, Matar A. Salivary Lead Levels among Workers in Different Industrial Areas in the West Bank of Palestine: a Cross-Sectional Study. Biol Trace Elem Res 2021; 199:4410-4417. [PMID: 33394307 DOI: 10.1007/s12011-020-02567-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/27/2020] [Indexed: 12/19/2022]
Abstract
Saliva is a biofluid that can easily be obtained and used for biomonitoring lead levels in occupationally and environmentally exposed individuals. The aims of this study were to determine salivary lead levels among workers in different industrial areas in the West Bank of Palestine and investigate the association between sociodemographic and occupational characteristics of the workers and their salivary lead levels. Salivary samples were obtained from workers in different industrial areas in metal-free polyethylene tubes. The samples were analyzed for their lead contents using a pre-validated inductively coupled plasma-mass spectrometric method. A total of 97 salivary samples were analyzed. The median salivary lead level was 1.84 μg/dL an IQR of 5.04 μg/dL. Salivary lead levels were significantly higher in workers who were 40 years and older (p value = 0.031), had 3 children or more (p value = 0.048), worked in repair workshops (p value = 0.012), worked in industrial areas for 20 years or more (p value = 0.048), did not consume fruits on regular basis (p value = 0.031), and smoked for 30 years or more (p value = 0.013). Multiple linear regression showed that smoking of 30 years old or more was a significant (p value < 0.001) predictor of higher salivary lead levels. Salivary lead levels among workers from different industrial areas of the West Bank were comparable to those occupationally exposed to lead in more industrialized and urbanized areas of the world. Smoking was a predictor of higher salivary lead levels.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building: 19, Office: 1340, P.O. Box 7, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Ahed Zyoud
- Department of Chemistry, Faculty of Science, An-Najah National University, Nablus, Palestine
| | - Omar Naseef
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Kamil Muwafi
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Abdullah Matar
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
4
|
Shawahna R, Samaro S, Ahmad Z. Knowledge, attitude, and practice of patients with type 2 diabetes mellitus with regard to their disease: a cross-sectional study among Palestinians of the West Bank. BMC Public Health 2021; 21:472. [PMID: 33750352 PMCID: PMC7941958 DOI: 10.1186/s12889-021-10524-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/01/2021] [Indexed: 02/07/2023] Open
Abstract
Background In Palestine, type 2 diabetes mellitus (T2DM) is a rapidly growing health concern. This study evaluated knowledge, attitude, and practice of patients with T2DM with regard to their disease. The study also investigated association and correlation between knowledge, attitude, and practice with sociodemographic and clinical characteristics of the patients. Predictors of higher knowledge, positive attitude, and good practice were also identified. Methods This cross-sectional study was conducted in primary healthcare facilities frequently visited by patients with T2DM across the West Bank of Palestine in the period of October 2018 to January 2019. An interviewer administered questionnaire was used to determine knowledge, attitude and practice of patients with T2DM with regard to their disease. Results Out of 300 patients invited, 220 (73.3%) patients responded. In this study, the median age was 57.0 years (51.0, 65.0), the median time elapsed since diagnosis with T2DM was 7.0 years (4.0, 14.0), the median fasting blood glucose was 150.0 mg/dL (128.8, 180.0), the median postprandial glucose was 230.0 mg/dL (200.0, 270.0), the median HbA1c was 7.8% (7.0, 8.53), and the median BMI was 28.8 kg/m2 (25.5, 33.1). The median knowledge score was 6.0/13.0 (4.5/13.0, 7.5/13.0), the median attitude score was 3.0/4.0 (2.0/4.0, 4.0/4.0), and the median practice score was 3.0 (1.0/5.0, 4.0/5.0). Having university education was strongly associated with having higher knowledge scores (p-value = 0.001). Additionally, having attended an educational program on diabetes was moderately associated with higher practice scores (p-value = 0.026). Conclusions Findings of this study highlighted the need for appropriately designed interventions to increase knowledge about T2DM among patients with low educational level. Well-designed educational programs might promote healthy practice among patients with T2DM. Future studies are still needed to assess if such interventions could be effective in improving health outcomes and quality of life of patients with T2DM in Palestine.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine & Health Sciences, New Campus, Building: 19, Office: 1340, An-Najah National University, P.O. Box 7, Nablus, Palestine. .,An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Saed Samaro
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zaid Ahmad
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
5
|
Shawahna R, Hattab S, Al-Shafei R, Tab’ouni M. Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students. BMC Psychiatry 2020; 20:244. [PMID: 32429889 PMCID: PMC7236464 DOI: 10.1186/s12888-020-02658-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Co-existence of depression and anxiety can be associated with severe detrimental consequences to the physical, mental and social wellbeing of the affected populations. This study was conducted to determine prevalence of depressive and anxiety symptoms among Palestinian medical students and to investigate associations between sociodemographic factors of the students with depressive and anxiety symptoms. METHODS This study was conducted in a cross-sectional observational design using a questionnaire in the period between September 2018 and April 2019 in a major university in the West Bank of Palestine. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI). The questionnaire also collected the sociodemographic characteristics of the students. Reliability of the questionnaire was tested using the test re-test method. A total of 425 medical students were invited to participate in the study. RESULTS Of those invited, 286 students completed the questionnaire, giving a response rate of 67.3%. More than half (56.6%) of the students had minimal depression, 20.3% had mild depression, 14.0% had moderate depression, 9.1% had severe depression, 23.4% had no anxiety, 29.7% had mild to moderate anxiety, 25.5% had moderate to severe anxiety, and 21.3% had severe anxiety. Multiple linear regression analysis showed that academic stage (p-value < 0.01), Grade Point Average (p-value < 0.01), mental health status (p-value < 0.001), ever attempted suicide (p-value < 0.05), and religious commitment (p-value < 0.01) were predictors of BDI-II scores. Multiple linear regression analysis showed that academic stage (p-value < 0.05) and mental health status (p-value < 0.001) were predictors of BAI scores. CONCLUSIONS Depressive and anxiety symptoms were prevalent among Palestinian medical students in a major university in the West Bank of Palestine. Interventions might be designed to improve self-rated mental health of medical students in their academic years, ameliorate study conditions, and provision of counseling services to improve spirituality might be effective in reducing symptoms of depression and anxiety among medical students in Palestine. Future studies are still needed to investigate if these interventions could be useful in reducing depressive and anxiety symptoms among Palestinian medical students.
Collapse
Affiliation(s)
- Ramzi Shawahna
- grid.11942.3f0000 0004 0631 5695Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine ,grid.11942.3f0000 0004 0631 5695An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine
| | - Suhaib Hattab
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine.
| | - Rami Al-Shafei
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mahmoud Tab’ouni
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|