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Pre-senile cataract is the opacity of the crystalline lens of the eye before the age of 50 years. Recently, the incidence of early-onset cataracts has been on the rise. It is closely linked with oxidative stress and antioxidant deficiency. To identify the relationship between serum antioxidant levels (vitamin E and glutathione) and the occurrence of pre-senile cataract, to measure serum vitamin E and glutathione levels in patients with pre-senile cataract and compare them with those of people without a cataract, to determine the effect of dietary habits and socioeconomic status on pre-senile cataract patients and identify the relationship between anthropometric measurements and occurrence of pre-senile cataract, a retrospective case–control study was conducted at an eye hospital in Gaza City. The study consisted of 44 cases of pre-senile cataract patients and 44 cases of region-, sex-, and age-matched controls. Data collection was performed by direct methods that included anthropometric measurement and serum vitamin E and glutathione levels and indirect methods through a structured interview questionnaire. SPSS software version 24 was used to analyze the data. Regarding serum antioxidant status, serum vitamin E and glutathione levels in pre-senile cataract patients were equal to those of healthy controls. The majority of patients were illiterate, married women. An increase in body weight and obesity had a strong association with pre-senile cataract formation. Concerning dietary factors, a high intake of fruits, meat and meat products, starchy food (grains), and healthy snacks was inversely correlated with pre-senile cataract. A direct relationship between vitamin E and glutathione was found. The study concluded that pre-senile cataract is a multifactorial disease and many risk factors (dietary factors, socio-economic factors, medical factors, and anthropometrics factors) play a role in pre-senile cataract formation. Full article

Congenital Hemophilia is an X-linked bleeding disorder caused by a deficiency of coagulation factor VII (in hemophilia A) or factor IX (in hemophilia B). The deficiency is the result of mutations of respective clotting factor genes. In the Gaza strip, 124 cases of hemophilia were observed. The main treatment for those patients is replacement of the missing factors along with supportive measures. To our knowledge, no studies were conducted in the Gaza Strip concerning nutritional status in hemophilic patients. A descriptive study that utilized a questionnaire to assess nutritional status among 27 adult male hemophilic patients managed at the Hemophilia and Thalassemia Clinic in the European Gaza Hospital from March to April 2019 was conducted. All the patients fully answered the questionnaires that included sociodemographic, socioeconomic, medical, nutritional and anthropometric characteristics. The diet diversity score for all the participants patients using mean (SD) was the following: Starches, 9.8 (0.769); Beverages, 9.6 (1.000); Vegetables, 7.8 (1.545); Fruits, 6.7 (2.215); Snacks, 6.3 (3.667); Legumes, 6.8 (1.459); Poultry, 5.0 (0.337); Meat, 4.9 (1.154); Eggs, 4.7 (1.846); Grains, 4.5 (2.375); Dairy Products, 4.2 (2.991); Soups, 4.1 (2.100); Fish, 3.8 (2.088); Nuts, 3.7 (2.270); and Sweeteners, 3.4 (2.857). Notably, only 17 patients (63.0%) were aware of the current dietary reference intakes. Moreover, most participants acknowledged the importance of providing nutritional patient education. In addition to medical treatment, hemophilic patients need to improve their nutritional status. This can be achieved through education and increase in patient awareness. Full article

Metabolic syndrome (MetS) is considered the most significant global health issue that is defined as constellations of interrelated cardiometabolic disorders including central obesity, insulin resistance, dyslipidemia, and hypertension. Studies indicated that high-sensitivity C-reactive protein (hs-CRP) has a role in the development of MetS and vice versa. No studies illustrated this association among physicians in the Gaza Strip, Palestine. The aim of this paper is to determine the prevalence of MetS among physicians and to identify the relationship between hs-CRP and MetS and lifestyle factors. A cross-sectional study design was adopted among healthy physicians in MOH, Gaza Strip. Data were collected from 300 participants (48.7% female and 51.3% male); they did not suffer from chronic disease or current infection or inflammation. Demographic data, anthropometrics, blood pressure, biochemical measurements, and lifestyle data were obtained from all participants. NCEP ATP III criteria were used to diagnose MetS. The majority of the study population (67.4%) were having high BMI > 25 kg/m². 63.0% with low HDL. The prevalence of MetS was 34.0%, and about half of the remaining participants had two diagnostic criteria for MetS. There were statistically significant differences in gender and age with MetS (p < 0.05). Also, the finding indicated a significant mean difference in hs-CRP and MetS groups. Moreover, there were no statistically significant differences between the MetS group in all food group consumption scores except in the fruits group, moreover, a significant correlation between hs-CRP and FBS, TG, BMI, and WC in females. The prevalence of MetS among healthy physicians was more than a third of the participants. More importantly, this study indicated a relationship between hs-CRP in participants with MetS. In addition, participants with MetS were found to have higher BMI, WC, WHR, FBG, TG, and lower HDL than non-MetS, and there was a relationship between the last components and hs-CRP. Full article

Cancer is a challenge for the majority of the population’s health-related quality of life (HRQoL), compromising their physical health and emotional well-being. This study aimed to assess the QoL, differentiate QoL among different groups, and explore its association with other factors in adult cancer patients undergoing chemotherapy treatment. All adult newly diagnosed cancer patients from the Oncology Department at the European Gaza Hospital (EGH) were eligible for participation in an ongoing prospective short cohort study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core30 (EORTC QLQ-C30 was used to assess QoL in cancer patients after the completion of the chemotherapy regimen. A simple, self-administered assessment tool, Patient Neurotoxicity Questionnaire (PNQ) which is increasingly used in clinical praxis with significantly positive results has been used. The mean age of patients was 48.58 years. The global health status and functional scales, in most domains, were low, while the symptoms scales were moderate-to-high for most items, showing worse QoL. Fatigue and pain were the most disturbing symptoms. Global health and social functioning were better in over-weight and obese patients (p < 0.05). Malnourished patients and patients at risk of malnutrition showed a worse level of global health status in comparison to well-nourished patients (p = 0.049). Cancer stage significantly affects QoL (p < 0.05). The correlation of functional scales with global health status was found higher; the Spearman correlation r > 0.30 and showed a significant positive relationship (p < 0.05). Patients with a high PNQ score (more severe chemotherapy-induced peripheral neuropathy (CIPN) symptoms) reported a worse global quality of life and worse physical, work, emotional, cognitive, and social functioning compared with those with a low PNQ score. Cancer patients had a worse QoL regarding overall global health status as well as functional and symptom scales. CIPN is associated with HRQoL in cancer patients. Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patients’ lives. Full article

Oxidative stress is defined as the excessive production of reactive oxygen species (ROS) and reactive nitrogen species in the presence of diminished antioxidant substances. It has been shown that oxidative stress disrupts the normal glucose metabolism in type 2 diabetic patients. The authors aimed to study the effect of vitamins C and E on oxidative stress among diabetes mellitus Type 2 patients in Gaza City, Palestine. The purpose of this study was to evaluate the effects of vitamins C and vitamin E as an adjunctive therapy in reducing the Erythrocyte Sedimentation Rate, Malondialdehyde (MDA), hs-CRP, and Total cholesterol in the sera of type 2 diabetes mellitus patients in Gaza City. To achieve this study, one hundred and sixty-eight (168) diabetic patients were selected from Gaza City. The diabetic patients (117) were treated with anti-diabetic agents such as metformin and divided into three groups; the first group was a control group that received anti-diabetic agents metformin only; the second group received vitamin C (1000 mg) along with metformin; whereas the third group received vitamin C (1000 mg) and vitamin E (400 mg), together along with metformin. All patients were followed up for 3 months. The results showed more significant reductions in the MDA, Hs-CRP, and cholesterol levels among the patients who used vitamin C and combinations of vitamins C and E compared to those of the control group after 3 months. The reduction of MDA is larger in the vitamin C and E group than it was in the vitamin C group alone, and the reduction in cholesterol was similar in both groups, but there was not any improvement in the level of ESR. The study revealed that the use of antioxidants like vitamin C and vitamin E can decrease the severity of oxidative stress and decrease the level of inflammatory markers, and it improves the total cholesterol level, so antioxidants can improve diabetes mellitus and its complications. Full article

A large amount of research has established that honey has potent antibacterial activity. However, the sensitivity of infection-causing viral species to honey has been scarcely studied. This study was designed to evaluate the effect of Manuka Honey eye drops among patients diagnosed with adenovirus conjunctivitis. Sixty-one patients with adenovirus keratoconjunctivitis were recruited in this quasi-experimental, multi-center study. All eligible subjects were randomly categorized into two groups: the first group was the control group, which was treated with steroids (conventional treatment), while the second group was the intervention group, which was treated with Manuka Honey drops at a concentration of 16.5% four times per day with conventional treatment (steroids). Symptoms in both groups, as well as the total ocular symptom score (TOSS), were compared. The results of the experimental group demonstrate the effectiveness of Manuka Honey eye drops in relieving symptoms of adenovirus keratoconjunctivitis. The findings of this study indicated that there was a statistically significant difference between the groups in terms of the number of days they had adenovirus keratoconjunctivitis (p > 0.001). Also, the mean itchy, redness, and tearing scores on day 4 among the patients in the intervention group were less than those in the control group (p > 0.001). In addition, the TOSS score on day 4 and day 8 among the patients in the intervention group was extremely lower than those in the control group (p > 0.001). The results of this study have shown important improvements in the symptoms of adenovirus keratoconjunctivitis. Our findings showed positive results within a short period, meaning that our results suggest that Manuka honey eye drops show promise as an adjunct natural treatment and that prescribing them in conjunction with conventional steroids can help alleviate the symptoms of adenovirus keratoconjunctivitis. Full article

Diet is an important cause that may affect the course of non-infectious diseases. Students may be subject to stressors, anxiety, insomnia, and bad nutritional habits. The present study was conducted to investigate the relationship between the levels of anxiety, insomnia, fast and junk food among Gazan Palestinian university students. This cross-sectional study of university students of both genders from different majors at Al-Azhar University and Palestine Technical College used random sampling techniques. After receiving ethical approval, data were collected using a validated questionnaire. The generalized Anxiety Disorder Questionnaire (GAD-7), Insomnia Severity Index (ISI), and Glasgow Sleep Effort Scale (GSES) were used to assess the nature and severity of anxiety. A short-self-administered questionnaire for fast and junk food was also used. More than 80% of participants had anxiety. In addition, 75.9% of participants had insomnia. This study showed significant positive associations between anxiety level and insomnia, and there was a statistically significant positive correlation between anxiety level insomnia fast and junk food consumption. The findings indicated that there was no statistically significant difference between the socioeconomic, demographic, and educational characteristics of the respondents with regard to anxiety and insomnia. Moreover, there was no statistically significant difference between these characteristics and the consumption of fast and junk food. It was determined that anxiety level might increase as insomnia level increases. In addition, both anxiety and insomnia might increase when the consumption of fast and junk food increases. Full article

Malnutrition is an important factor in the survival of critically ill patients. Detailed nutrition assessment enables the early identification of malnourished patients and improves patient outcomes. To determine the prevalence of malnourished critically ill patients and assess the criterion validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) among critically ill Palestinian patients against the reference standard for malnutrition, the Subjective Global Assessment (SGA), a cross-sectional study was conducted among 100 critically ill patients with a mean age of 43.9 ± 16.39 who were admitted to the ICU in main governmental hospitals in Palestine, from July 2020 to November 2020. The sensitivity, specificity, PPV, and NPV of the AND-ASPEN were analyzed against the SGA. ROC curve analysis was used to obtain the AUC and suitable optimal cutoff values for AND-ASPEN. According to the SGA and AND-ASPEN, 71% and 54% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the AND-ASPEN were 0.718, 0.896, 0.944, and 0.565, respectively. The AUC of the AND-ASPEN was comparable to the SGA (0.859). The prevalence of malnutrition remains high among critically ill patients. The validity of the AND-ASPEN is comparable to the SGA, and the use of the AND-ASPEN to assess the nutritional status of this group is proposed, as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished critically ill patients and improving the quality of the nutritional care process practiced in Palestine. Full article

Childbearing women on combined oral contraceptive agents (COCAs) have been linked with the development of various diseases and possible deficiencies in serum micronutrients. This study aimed at investigating the vitamins and trace mineral changes associated with the use of COCAs among child-bearing healthy women in the Gaza Strip. A comparative cross-sectional study was designed. After informed consent was obtained, questionnaires, anthropometric measurements, and blood samples were collected from a total of 90 women of childbearing age (45 used different contraceptive methods, and 45 used COCAs). The mean hemoglobin, hematocrit, and red blood cells that obtained from the COCAs users group were significantly lower than those in the non-users group (p < 0.001, p = 0.073, and p = 0.047, respectively). There was a significant association between the use of COCAs and cholesterol level (p = 0.044). In addition, there was a statistically significant difference in the levels of homocysteine and vitamin B6 between the groups (p = 0.008 and p = 0.010, respectively). The present study indicated the possibility of micronutrient deficiencies in women on combined oral contraceptive agents. Full article

Droughts during the growing season are projected to increase in frequency and severity in Iran. Thus, area-wide monitoring of agricultural drought in this region is becoming more and more important. Changes in precipitation patterns are caused by extreme weather events such as drought which strongly affect agricultural production. In this study, two data sources are used in drought assessment. First, by calculating the Standardized Precipitation Index (SPI) in the periods of 1 month, 3 months, 6 months, and one year in the western agricultural areas of Isfahan province in the time series from 2016 to 2019, precipitation data were used to analyze and evaluate meteorological drought’s spatial and temporal dynamics. Furthermore, the average loss of rainfall was calculated using TRMM satellite monthly rainfall data and the average NDVI monthly with Landsat 8 satellite images using remote sensing data. Then, the Composite Drought Index (CDI) is produced to assess agricultural drought in the 2017–2018–2019 time series. The correlation between the CDI and SPI varies between 0.19 and 0.81 in different months in the time series. The correlation between temperature and CDI in different months varies from 0.22 to 0.75 and between evaporation and CDI from 0.25 to 0.70 in the time series. Full article

In order to analyse the exposure-response relationship between hand–arm-vibration exposure and the risk of musculoskeletal disorders (MSDs) of upper extremities in an epidemiological case-control study, a database was established to provide technical characteristics such as vibration exposure data and its frequency component measured at workplaces. This hand-arm vibration database consists of over 730 technical tools and devices, whereas 422 devices were used for exposure assessment in the epidemiological case-control study. The devices used were divided into a total of 13 device groups: hammers, grinding machines, compactors, screwdrivers and saws were the most frequently used devices. Full article