The epidemiology of gestational diabetes, gestation hypertension, and anemia in North Palestine from 2018 to 2020: A retrospective study

BACKGROUND

In Palestine, women face a challenging environment and a demanding lifestyle, which puts them at a higher risk of experiencing complications during pregnancy. This study aimed to examine the risk factors linked with abnormal hemoglobin (Hb) levels, gestational diabetes (GD), and gestational hypertension (GH) among pregnant women. The results was compared between women residing in cities or villages areas and those in refugee camps.

METHODS

Medical records (N = 7889) for pregnant women at primary healthcare centers in the North West Bank were reviewed for sociodemographic and medical data along with the reported fasting blood sugar, hemoglobin, and blood pressure in the first and second trimesters from July 2018 to July 2020. However, only 6640 were included in the analysis as 1249 were excluded for having multiple pregnancy or lost to follow up. Complications and risk factors were defined according to the available global guidelines. Then, descriptive analysis was used to show the percentages of different risk factors and complications among them. The correlation between the several characteristics and variables with these complications was assessed by calculating the odds ratios (OR) using logistic regression. P-values of <0.05 were considered significant.

RESULTS

The prevalence of adolescent pregnancy was the highest among women living in rural areas (9.8%) and grand multigravidity among refugee women (22%). The overall prevalence of anemia was higher in the second-trimester (16.2%) than in the first-trimester (11.2%), with anemic women in the first-trimester being more likely to be anemic in the second-trimester (OR = 8.223, P-value<0.001). Although anemia was less common in the first-trimester among refugees than among women living in urban areas (OR = 0.768, P-value = 0.006), it was more prevalent in the second-trimester (OR = 1.352, P-value<0.001). Moreover, refugee women were at lower risk than women living in urban areas of having GD (OR = 0.687, P-value<0.001) and diabetes mellitus (OR = 0.472, P-value<0.001) in the second-trimester. GH was associated with GD (OR = 1.401, P-value = 0.003) and DM (OR = 1.966, P-value<0.001).

CONCLUSION

The findings of this study provide evidence-based data on the considerable prevalence of pregnancy complications, anemia, GD, and GH among Palestinian pregnant women living in the north of the West Bank. Multi gravida, gestational age, Hb levels, and the type of settings were strong predictors of pregnancy complications. Therefore, a national plan is needed to ensure adequate maternal care for all, especially disadvantaged women, those in rural areas and refugee camps.

Bacteriological profile and antibiotic susceptibility pattern of septicemia in neonatal intensive care units in Palestine: A retrospective study

Objectives

The aim of this study was to identify the prevalent pathogens that caused neonatal septicemia and their corresponding antimicrobial sensitivities in the neonatal intensive care unit (NICU) in the West Bank.

Methods

In this retrospective study, we extracted records of neonates with suspected neonatal sepsis (NS) admitted to three NICUs in the West Bank between 2019 and 2021 from the Ministry of Health's electronic database.

Results

Out of 6090 suspected episodes of NS, 884 tested positive for blood cultures, and 554 were primary cases; 59.5% were male, 26.6% were preterm, and 52.7% were aged 0-7 days. Moreover, 29% of 884 positive cultures were contributed by multidrug-resistant organisms (MDRO). Only 14.6% of episodes aligned with both Word Health Organization-recommended antibiotic regimens, 5.2% matched with one regimen, and 80.3% did not match either regimen. Specifically, 19.6% of cases matched with ampicillin-gentamicin, and 14.7% matched with ampicillin-cefotaxime. The likelihood of a match between early-onset sepsis and empiric antibiotic regimens was greater than late-onset sepsis (odds ratio = 2.549, [95% confidence interval: 1.276-5.092]). MDRO was more likely than non-MDRO to match with one antibiotic regimen (odds ratio = 4.142 [95% confidence interval: 1.913-8.966]).

Conclusion

There is an alarming prevalence of MDRO among Palestinian neonates in the NICU of the West Bank. The study highlights the urgent need for implementation of effective infection control measures and antimicrobial stewardship programs in the NICUs of hospitals in the West Bank to reduce the prevalence of MDRO and improve neonatal health outcomes.

Energy drinks and waterpipe smoking associated with disordered eating habits among male Palestinian refugees

This cross-sectional study highlights the concerning relationship between stimulants, alcohol use, and weight-related problems among Palestinian refugee men in the West Bank. Self-administered questionnaires were used to gather data on stimulants and alcohol use and eating attitudes and behaviors (EAT-26). The findings revealed that many refugee men were daily cigarette (61.4%) and waterpipe smokers (15.5%), while 30.6% and 2.3% were daily energy drink and alcohol users, respectively. Moreover, most refugee men (67.3%) were obese, and 23.5% were terrified about being obese. They had disordered eating habits, including the impulse to vomit after meals (63.3%). Moreover, 30.7% scored ≥20 using EAT-26 scale, and 44.4% scored at least one positive behavior, including binge eating (40.4%), purging (10.0%), using laxatives or diet pills (8.3%), excessive exercise (30.9%), and losing weight (24.6%). The results of the adjusted binary logistic regression indicated that risk factors associated with self-induced vomiting were daily (OR = 2.71, p-value = 0.004) and weekly energy drink intake (OR = 2.41, p-value = 0.023), weekly alcohol intake (OR = 10.83, p-value = 0.036), and obesity (OR = 2.57, p-value = 0.002), while inversely associated with weekly waterpipe smoking (OR = 0.297, p-value = 0.007). Obesity was inversely associated with daily (OR = 0.146, p-value < 0.01) and weekly waterpipe smoking (OR = 0.259, p-value = 0.002), and weekly cigarette smoking (OR = 0.251, p-value < 0.01). The study underscores the urgent need for community awareness, professional evaluation, and treatment for obesity and disordered eating habits among Palestinian refugee men. It is essential to address the detrimental effects of alcohol and energy drink intake and tobacco smoking to improve the health outcomes of this vulnerable population.

High-risk drug use among Palestinian adolescent refugees in the North West Bank Palestine

Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use. This research focuses on the prevalence of substance use and its relationship with depression among adolescent male refugees in Palestine's North-West Bank. A cross-sectional study was conducted in five of seven refugee camps to gather data using a proportional stratified sampling technique. A structured questionnaire-based interview was conducted to gather sociodemographic data, self-reported substance use, and depression scale information. Additionally, urine screening tests were used to detect the presence of different drugs in participants' urine samples. The final sample size was 386 refugee males; 24.0% were workers, and 13.7% worked previously. For self-reported substance use, 26.9%;12.4%; 28.0%; 37.0%; and 60.4%, 2.6% of adolescents reported current users of cigarettes, e-cigarettes, waterpipe, coffee, energy drinks (ED), and alcohol, respectively. Moreover, 3.4% tested positive for at least one drug. The drugs that tested positive were as follows: PCP (5%), MDMA (1.8%), THC (1.6%), BZO (0.5%), and MET (0.5%). The adjusted logistic regression showed an increased risk of depression among workers (OR = 3.777; p-value = 0.008), cigarette smokers (OR = 2.948; p-value = 0.04), waterpipe smokers (OR = 4.458; p-value = 0.041), and coffee users (OR = 2.883, p-value = 0.046). In conclusion, Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use, including illicit drugs, alcohol use, tobacco smoking, and ED intake. The results of this study reveal alarming figures on drug use associated with depression in refugee camps which demand controlling interventions.

The epidemiology of substance use in the West Bank: Who is at risk?

Illicit drug use is bound by a religious, social, and cultural stigma in Palestine. The extent of illicit drug use in Palestine is difficult to estimate due to the limited availability of research and challenged by poor measurement and inconsistent reporting. Concern about the hidden nature of drug use continues to be reported. We investigated the prevalence and risk factors associated with illicit drug use in the north of the West Bank. We compared the results between refugee camps and rural and urban areas. The recruited males (N = 1045) were invited to fill out a self-administrated questionnaire and to give urine samples in 2022. Multi-line drug screen test in urine was used as a screening tool to evaluate the presence of 12-drugs in urine samples. The respondents (N = 656) were aged 15-58 years. At least one drug was detected positive in 19.1% of the participants' urine samples, with the highest percentages among refugees (25.9%), followed by rural (13.6%) and urban participants (10.9%) (P-value < 0.001). Moreover, around half of the drug users were multidrug users. Refugees were 3.8 times (P-value = 0.002), and urban were 2.3 times (P-value = 0.033) more likely to be drug users than rural participants. Besides the geographical factors, socio-demographic factors like age (<30 years), marital status (single), drinking alcohol, and vape-smoking played significant roles in the increasing risk of illicit drug use in the West Bank. The findings from this study draw attention to our limited understanding of the epidemiology of substance use among Palestinians.

Energy drinks, depression, insomnia and stress among Palestinians: The mediating role of cigarettes smoking, electronic cigarettes and waterpipe

We investigated the association between energy drinks, depression, insomnia and stress among Palestinians and whether cigarette smoking, electronic cigarettes, and waterpipe mediate the association between these variables. Our study sample consisted of 506 Palestinian adults: 120 men and 386 women recruited from online advertisements, e-mail campaigns and social media. Findings showed a positive correlation between energy drinks, depression, insomnia, and stress. While a positive correlation was found between energy drinks, cigarette smoking, electronic smoking and waterpipe. Results of path analysis showed that energy drinks, cigarette smoking, electronic smoking and waterpipe mediated the correlation between energy drinks, insomnia, depression and stress. Thus, there is an urgent need to increase community awareness regarding the adverse effects of excessive energy drink consumption among Palestinians. Accordingly, training programs, workshops, and open days targeting Palestinians to improve awareness of the adverse effects of energy drinks on physical and mental health are crucial to reducing Palestinians' extensive use of energy drinks.

Metabolic syndrome and related risk factors among adults in the northern West Bank, a cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that includes central obesity, insulin resistance, dyslipidaemia and hypertension. The aim of this study was to establish the prevalence of MetS and its associated risk factors among adult Palestinians using the International Diabetes Federation definition.

METHODS

A total of 1348 subjects ages 18-65 y were recruited in a cross-sectional study that was conducted in 2018-2019 in the northern West Bank.

RESULTS

A total of 1082 subjects participated; 51.7% were men. The prevalence of MetS was high (44.9%), and higher among women (46.1%) than men (44.2%) (p<0.001). The prevalence increased significantly with increasing age and body mass index (BMI) in both genders (p<0.001). However, metabolically obese but normal weight individuals (MONW) (8.4%) were also identified, with a slight increase among women (9.4%) compared with men (7.5%) (p=0.56). MetS was more likely to be prevalent among participants with increased fasting blood sugar (5.8 times), increased triglyceride (7.4 times), increased blood pressure (4.5 times) and BMI ≥25 (19.9 times) (p<0.001). The prevalence of MetS was higher among rural (50.3%) vs urban (39.3%) residents and refugees (33.8%).

CONCLUSIONS

With increasing age and obesity, clustering of MetS components increased remarkably in both genders. Effective prevention and treatment strategies for MetS and its risk factors should be developed targeting different ages and genders.

Risk of Tobacco Smoking and Consumption of Energy Drinks on Obesity and Central Obesity Among Male University Students

Background

Obesity is one of the leading causes of morbidity and premature death. The prevalence of obesity and being overweight in young adulthood is increasing exponentially globally, including Palestine. Consumption of energy drinks (EDs) and tobacco smoking are highly prevalent among Palestinian young adults. Although different studies have demonstrated that the use of caffeine and tobacco products is highly prevalent among Palestinians, especially university students, the adverse effects of these products on obesity have not been thoroughly investigated.

Methodology

Male students from An-Najah National University in the West Bank were recruited to fill out a self-administrated questionnaire in this cross-sectional study conducted in 2021. Obesity was measured as total adiposity by calculating body mass index (BMI) and as central obesity by measuring waist circumference. To determine the association between obesity and ED consumption and tobacco smoking, we used adjusted multiple logistic regression models. Shapiro-Wilk’s test was used to assess the normality of the data.

Results

A total of 396 students filled the questionnaire, with a response rate of 89.4%. The prevalence of obesity and central obesity was 42% and 35.75%, respectively. The prevalence of ED consumption, cigarette smoking, and waterpipe smoking was 59.6%, 39.6%, and 43.2%, respectively. ED consumers were more likely to be cigarette smokers (odds ratio (OR) = 3.827, P < 0.001), waterpipe smokers (OR = 4.578, P < 0.001), and chocolate consumers (OR = 3.524, P = 0.001). Central obesity was associated with waterpipe smoking (OR = 2.126, P = 0.044), increased age (OR = 1.367, P = 0.001), and increased BMI (OR = 1.927, P < 0.001). On the other hand, cigarette smokingincreased the risk of being underweight (OR = 6.255, P = 0.012), and ED consumption decreased the risk of being obese (OR = 0.183, P = 0.017).

Conclusions

Waterpipe smoking was a risk factor for increased central obesity, and ED consumption was associated with decreased; however, smoking was associated with the underweight BMI category. Given the undesirable health consequences of consuming the closely associated tobacco and EDs, stricter measures are needed to prevent access to these products.

Assessment of the Relationship of Depression With Tobacco and Caffeine Use Among University Students: A Cross-Sectional Study

Background

University students are at a higher risk of using cognitive enhancers and psychoactive substances. Depression is associated with a noticeable decline in academic performance and can increase the risk of substance use. Due to sociopolitical issues, the use of cognitive enhancers and psychoactive substances among Palestinians has spread in the last decade. However, depression among tobacco and caffeine users remains underrecognized and neglected.

Methodology

A self-administrated questionnaire and the Beck Depression Inventory were used to assess the association of depression and the use of cognitive enhancers and psychoactive substances among university students at An-Najah National University in 2020.

Results

The response rate to the questionnaires was 78.8% (n = 1,051; 38.8% males, 61.2% females). The overall prevalence of depression was high (30.6% males, 34.7% females). The prevalence of cigarette smoking (39.2% males, 3.9% females), waterpipe smoking (43.1% males, 21.6% females), energy drink consumption (59.6% males, 29.7% females), coffee consumption (85.5% for each gender), tea consumption, and chocolate consumption was high, with significant differences in accordance to gender and academic fields. The multinomial logistic regression results revealed that cigarette smokers were more likely to have a higher risk of severe (odds ratio [OR] = 4.5, p = 0.001), moderate (OR = 3.27, p < 0.001), and mild depression (OR = 2.24, p = 0.002) than non-smokers. Severe depression was less prevalent among medical students than health sciences and non-medical students (OR = 0.215, p = 0.015). Moreover, males were less likely to have moderate (OR = 0.5, p = 0.012) and mild (OR = 0.48, p = 0.001) depression than females.

Conclusions

Overall, the results of this study revealed the high prevalence of depression and the detrimental effects of smoking on students. Moreover, the findings suggest the urgent need to address depression and risk factors among Palestinian university students by educating them about mental health, identifying high-risk students, and offering easily accessible psychological help. Further, it is crucial to broaden the focus of studies to include students from various academic fields instead of focusing on medical students.

The Association Between High Hemoglobin Levels and Pregnancy Complications, Gestational Diabetes and Hypertension, Among Palestinian Women

INTRODUCTION

Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the principal causes of maternal morbidity and mortality. The maternal morbidity and mortality burden for Palestinian women is relatively high, suggesting a substandard quality of care. Therefore, an early diagnosis of GDM and gestational hypertension (GH) can improve prenatal care for pregnant women and improve pregnancy outcomes. Previous studies demonstrated that elevated Hb levels in the first trimester indicate possible pregnancy complications and should not only be considered as good iron status. However, ethnic differences could play a role in determining the magnitude of the association. We hypothesized that high Hb levels (≥12.5 g/dl) in the first trimester (6-13 gestational weeks, GW) are associated with increased risk of fasting blood sugar (FBS) ≥126 mg/dl, systolic blood pressure (SBP) ≥140 mmHg, and diastolic blood pressure (DBP) ≥90 mmHg among pregnant Palestinian women visiting prenatal clinics in Palestine.

METHODS

Medical records (N=5263) were reviewed for singleton pregnancies who had their first maternity care clinic visit (6-13 GW) at primary healthcare centers of the Palestinian Ministry of Health in the north of the West Bank in 2018 and 2019. Women were excluded if they had FBS ≥92 mg/dl, SBP ≥140 mmHg, DBP ≥90 mmHg, ultrasound-based gestational age >13 weeks, or who were previously diagnosed with diabetes mellites, GDM, hypertension, GH, taking drugs for these conditions, or were smoking during pregnancy. Hb levels in g/dl were divided to low (<11.0), normal (11-12.49), and high (≥12.5). The associations between high hemoglobin levels and pregnancy complications in pregnant women were assessed by calculating the odds ratios (OR) and their 95% confidence intervals (CIs) using logistic regression. P-values of <0.05 were considered significant.

RESULTS

The final number of eligible records was 2565. Pregnant women with high Hb levels in the first trimester were at higher risk of high FBS (≥126 mg/dl; OR=2.99, 95%CI, [1.675-5.368]) and high systolic blood pressure (≥140 mmHg; OR=3.048, 95%CI, [1.252-7.421]) at 24 GW. Gravidity was significantly associated with decreased risk of high FBS (OR=0.838, 95%CI [0.704-0.991]).

CONCLUSION

Our findings suggest that Hb level at registration could be utilized in predicting the risk of GDM and HP among Palestinian women who never had a previous history of these conditions. The results of this study could have important clinical implications for early screening, which could improve preventive and curative health services to promote the health of pregnant women and children.

Metabolic Syndrome Associated with Tobacco and Caffeine Products Use Among Refugee Adolescents: Risk of Dyslipidemia

INTRODUCTION

Due to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problems related to tobacco and caffeine products, the most socially acceptable CE/PS among Palestinian refugee adolescents.

METHODOLOGY

In 2021, schoolchildren from five Palestinian refugee camps (N=271) aged 12-<16 years agreed to give blood samples and to be interviewed to address the association between metabolic syndrome (MetS) and tobacco smoking, coffee, energy drinks (ED), black tea, and chocolate consumption. MetS was diagnosed based on International Diabetic Federation Criteria. To address the association, we used binary logistic regression models adjusted to age, gender, BMI, and central obesity.

RESULTS

The prevalence of MetS was [17 (6.3%)]; (7.4%) in males, (5.1%) in females. The prevalence of substance use was as follows: ED [163 (48.9%)], coffee [255 (76.6%)], black tea [295 (89.1%)], cigarette [35 (10.5%)], waterpipe [59 (17.7%)], and chocolate [309 (93.6%)], with male predominance. Cigarette smokers have increased central obesity (p-value=0.024), and decreased HDL-cholesterol (p-value=0.015) than non-smokers. Similar results were observed for waterpipe smokers besides the increased levels of triglycerides (p-value=0.01). ED consumers have increased central obesity (p-value=0.03) and fast blood sugar (p-value=0.003) than non-consumers. Chocolate consumers have decreased central obesity (p-value=0.008) and increased HDL levels (p-value=0.04) than non-consumers. ED consumers were significantly at higher risk of MetS (OR=9.97, p-value=0.019) than non-consumers and chocolate consumers were at lower risk of MetS (OR=0.14, p-value=0.046) than non-consumers. Waterpipe smokers were at a higher risk of having increased plasma triglycerides than non-consumers (OR=3.4, p-value=0.03).

CONCLUSION

The high prevalence of ED consumption and waterpipe smoking in Palestinian refugee adolescents is problematic. Their use was associated with higher odds of MetS, dyslipidemia, and central obesity, which justifies greater attention.

Eating Disorders and the Use of Cognitive Enhancers and Psychostimulants Among University Students: A Cross-Sectional Study

BACKGROUND

University students, who are at risk of eating disorders (ED), are more liable to use cognitive enhancers and psychostimulants to improve their cognitive functions and lose weight. ED in Palestinian male students is a neglected health issue. We aimed to investigate the prevalence and the association between ED and cognitive enhancers, and psychostimulants use among An-Najah National University students (ANNU).

METHODS

In a cross-sectional study conducted in 2020 at ANNU, 1047 students completed anonymous surveys for cognitive enhancers practice, the Eating Attitude Test-26 (EAT-26), Sick, Control, One, Fat and FOOD (SCOFF) screening tests.

RESULTS

The prevalence of ED among ANNU students was 21.2% based on EAT-26 (17.1% in males, 23.8% in females) and 31.5% based on SCOFF (24.0% in males, 36.3% in females). The binary logistic regression revealed that students at risk to have ED were water-pipe smokers (OR: 1.471, p-value 0.047), especially males, while students who were less likely to have ED were males (OR: 0.341, p-value<0.001), coffee users (OR: 0.581, p-value 0.014) and chocolate users (OR: 0.530, p-value 0.041) than nonusers. Moreover, the risk of ED increased with increasing body mass index (p-value<0.01). Clinical medical students showed the lowest prevalence (11.1%) compared to preclinical (22.5%), health sciences (23.7%), and non-medical students (20.9%) (p-value 0.059).

CONCLUSION

Our findings highlight water-pipe smoking as a significant health problem in males with ED, which may require unique treatment and prevention strategies. Moreover, coffee and chocolate consumption were associated with decreased risk of ED, only among males. The gender-gap in ED prevalence was very narrow compared to international results. These results prompt the need to focus on both genders in future studies instead of females. They also suggest the urgent need to address ED among Palestinian university students by educating students about mental health, identifying high-risk students, and offering easily accessible psychological help.

Cyp2b-Knockdown Mice Poorly Metabolize Corn Oil and Are Age-Dependent Obese

We previously made a RNAi-based cytochrome P450 2b (Cyp2b)-knockdown (Cyp2b-KD) mouse to determine the in vivo role of the Cyp2b subfamily in xenobiotic detoxification. Further studies reported here indicate a role for Cyp2b in unsaturated fatty-acid (UFA) metabolism and in turn obesity. Mice were treated intraperitoneally (i.p.) with 100 μL corn oil as a carrier or the potent Cyp2b-inducer 3,3',5,5'-Tetrachloro-1,4-bis(pyridyloxy)benzene (TCPOBOP (TC)) dissolved in corn oil. Surprisingly, female Cyp2b-KD mice but not male mice showed increased liver lipid accumulation. Male Cyp2b-KD mice had higher serum triacylglycerols, cholesterol, very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) than wildtype (WT) mice; females had higher cholesterol, LDL, and HDL. Thus, Cyp2b-KD mice are unable to clear a high bolus dose of corn oil, potentially because the Cyp2b-KD mice were unable to metabolize the UFA in the corn oil. Therefore, WT and Cyp2b-KD mice were housed for 35 weeks and necropsies performed to test whether Cyp2b-KD mice develop age onset obesity. Cyp2b-KD mice exhibited a significant increase in body weight caused by an increase in white adipose tissue deposition relative to WT mice. Serum cholesterol, triacylglycerol, LDL, and VLDL were significantly greater in 35-week-old Cyp2b-KD males compared to WT males; only serum triacylglycerol and LDL were higher in females. In conclusion, changes in Cyp2b expression led to perturbation in lipid metabolism and depuration in Cyp2b-KD mice. This suggests that Cyp2b is more than a detoxification enzyme, but also involved in the metabolism of UFA, as Cyp2b-KD mice have increased the body weight, fat deposition, and serum lipids.

Characterization and prevalence of metabolic syndrome among overweight and obese young Palestinian students at An-Najah National University

OBJECTIVES

Metabolic Syndrome "MetS" is characterized by the presence of several factors that play a major role in the development of cardiovascular diseases and diabetes mellitus. This study was conducted to establish the prevalence of MetS and its individual components among the overweight and obese students at An-Najah National University (ANU) using IDF and modified NCEP ATP III definition and to identify conditions associated with it.

MATERIALS AND METHODS

A cross-sectional study was conducted in 2016. Data were collected in two stages: first stage included anthropometric and blood pressure measurements for 850 participants. Second stage included a self-administered questionnaire and biochemical analysis for only overweight or obese (154) participants.

RESULTS

The prevalence of overweight and obesity was 26.2%, with significant increase among males (36.4%) compared with females (19.1%). The prevalence of MetS among obese and overweight was (28.6%) according to IDF with no significant increase compared to NCEP ATP criteria (24%). Reduced HDL- cholesterol was the most prevalent component (74.7%) in obese and overweight participants followed by central obesity (72.1%), raised blood pressure (29.9%), elevated fasting blood sugar (24%), and lastly increased triglycerides (18.2%). No significant differences were found between males and females according to both criteria. Moreover, no significant associations with geographic locality, house-hold income, smoking, physical activity, or family history were determined.

CONCLUSIONS

The prevalence of MetS among overweight and obese young adult Palestinians was high and demands immediate intervention, given the potential for these adults to develop chronic diseases.

Metabolic syndrome among overweight and obese adults in Palestinian refugee camps

BACKGROUND

Metabolic syndrome (MetS) is one of the main reasons for elevated cardiovascular morbidity and mortality worldwide. Obese and overweight individuals are at high risk of developing these chronic diseases. The aim of this study was to characterize and establish sex-adjusted prevalence of metabolic syndrome and its components.

METHODS

A cross-sectional study was conducted in 2015, 689 (329 men and 360 women) aged 18-65 years from three refugee camps in the West Bank. International Diabetes Federation and modified National Cholesterol Education Program-Third Adult Treatment Panel definitions were used to identify MetS.

RESULTS

The overall prevalence of obesity and overweight was high, 63.1%; Obesity (42 and 29.2% in women men; respectively and overweight 25.8 and 28.9% in women and men; respectively. The prevalence of MetS among obese and overweight was significantly higher (69.4%) according to IDF than NCEP definition (52%) (p < 0.002) with no significant differences between men and women using both definitions; (IDF; 71.8% men vs. 67.6% women, and (NCEP/ATP III; 51.9% men vs. 52.2% women). The prevalence of MetS increased significantly with increasing obesity and age when NCEP criterion is applied but not IDF. The prevalence of individual MetS components was: high waist circumference 81.3% according to IDF and 56.5% according to NCEP, elevated FBS 65.3% according to IDF and 56% according to NCEP, elevated blood pressure 48%, decreased HDL 65.8%, and elevated triglycerides 31.7%. Based on gender differences, waist circumferences were significantly higher in women according to both criteria and only elevated FBS was higher in women according to IDF criteria. Physical activity was inversely associated with MetS prevalence according to NCEP but not IDF. No significant associations were found with gender, smoking, TV watching, and family history of hypertension or diabetes mellitus.

CONCLUSION

In this study, irrespective of the definition used, metabolic syndrome is highly prevalent in obese and overweight Palestinian adults with no gender-based differences. The contribution of the metabolic components to the metabolic syndrome is different in men and women. With the increase of age and obesity, the clustering of metabolic syndrome components increased remarkably. More attention through health care providers should, therefore, be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular diseases.

Antioxidant evaluation for Urtica urens, Rumex cyprius and Borago officinalis edible wild plants in Palestine

Natural plants products are one of the famous and commonly utilized remedies used in fighting diseases. This study was conducted to evaluate antioxidant activity of plants commonly used in Palestine (Urtica urens, Rumex cyprius and Borago officinalis). Free radical scavenging activity method was evaluated by using 2,2-diphenyl-1-picryl-hydrazyl-hydrate. The result show that the overall antioxidant activity of Rumex cyprius was the highest among the plants, followed by Urtica urens, and Borago officinalis; respectively. The (IC(50)) values of the methanolic extracts were 29.70±0.60μg/ml, 5.07±0.49μg/ml, 39.92± 0.52 μg/ml for Urtica urens, Rumex cyprius and Borago officinalis respectively. The results of this study revealed that these edible plants have high antioxidant activity and therefore they can provide natural sources of antioxidants and can be useful in preventing various diseases including cancer. These exhibited properties propose that such plants extracts can possibly be used as natural preservatives in the food and pharmaceutical industries and further characterization of Rumex cyprius constituents is needed.

Lentiviral-mediated RNAi knockdown yields a novel mouse model for studying Cyp2b function

There are few in vivo knockout models available to study the function of Cyp2 members involved in the metabolism of endogenous and exogenous chemicals. These models may help provide insight into the cytochrome P450s (CYPs) responsible for the detoxification and activation of drugs, environmental toxicants, and endobiotics. The aim of this work is to produce a potent Cyp2b-knockdown (KD) mouse for subsequent study of Cyp2b function. We made a quintuple Cyp2b-KD mouse using lentiviral-promoted short hairpin RNA (shRNA) homologous to all five murine Cyp2b subfamily members (Cyp2b9, 2b10, 2b13, 2b19, and 2b23). The Cyp2b-KD mice are viable, fertile, and without obvious gross abnormalities except for an increase in liver weight. Expression of the three hepatic Cyp2b members, 2b9, 2b10, and 2b13, is significantly repressed as demonstrated by quantitative real-time PCR and Western blotting. The constitutive androstane receptor activator, 1,4-Bis[2-(3,5-dichloropyridyloxy)] benzene (TCPOBOP), was used to determine if shRNA-mediated Cyp2b10 repression could be outcompeted by Cyp2b10 induction. TCPOBOP-treated Cyp2b-KD mice show 80-90% less Cyp2b protein expression than TCPOBOP-treated wild-type (WT) mice, demonstrating that Cyp induction does not outcompete the repressive function of the shRNA. Untreated and TCPOBOP-treated Cyp2b-KD mice are poor metabolizers of parathion compared with WT mice. Furthermore, Cyp2b-KD mice are sensitive to parathion, an organophosphate insecticide primarily metabolized by Cyp2b enzymes, when compared with WT mice. In summary, we designed an shRNA construct that repressed the expression and activity of multiple Cyp2b enzymes. We foresee that this novel Cyp2b-KD mouse model will significantly improve our understanding of the role of Cyp2b enzymes in chemical sensitivity and drug metabolism.