Waterpipe Tobacco Smoking and Other Multiple Sclerosis Environmental Risk Factors

2021 ◽  
Author(s):  
Nuha M. Alkhawajah ◽  
Salman Aljarallah ◽  
Laith Hussain-Alkhateeb ◽  
Mohammad Osama Almohaini ◽  
Taim A. Muayqil

Abstract Introduction There are a number of well-established risk factors for multiple sclerosis (MS). Other factors however, showed conflicting or non-consistent results. Here we examine some factors that are unique to or more practiced in Saudi Arabia (SA) and the Arab region such as waterpipe tobacco smoking (WTS), face veiling, raw milk (RM), and camel milk (CM) consumption, tuberculosis (TB) infection in addition to other traditional factors. Methods This is a sex and age matched case-control study in which we used a structured questionnaire to examine the relation between a number of factors and exposures and the risk of MS. Three hundred MS patients and 601 controls were included. Data was analyzed across different statistical models using logistic regression adjusting for age, sex, marital status, duration of breastfeeding, age first joining school, coffee consumption, and face exposure. Results Cigarette smoking [OR = 1.79, (95% CI 1.01-3.17), P =0.047)], WTS [OR = 2.25, (95% CI 1.21-4.15), P =0.010)], and CM consumption [OR = 2.50, (95% CI 1.20-5.21), P =0.014)] increased the risk of MS. While performing hajj [OR = 0.47, (95% CI 0.34-0.67), P =0.001)], TB infection [OR = 0.29, (95% CI 0.11-0.78), P =0.015)], face veiling [OR = 0.32, (95% CI 0.23-0.47), P =0.001)] and coffee consumption [OR =0.67, (95% CI 0.49-0.89), P =0.008)], appeared to be associated with decreased risk. No association was found between fast food, processed meat, soft drinks, animal milk (other than camel) or RM consumption and the risk of MS. Conclusion The results of this case-control study confirm that different means of tobacco smoking are associated with increased risk of MS. It also sheds more light on the complex association between infections and MS.

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ying Li ◽  
Alice Saul ◽  
Leigh Blizzard ◽  
Bruce Taylor ◽  
Anne-Louise Ponsonby ◽  
...  

Abstract Background Risk factors in Multiple Sclerosis (MS) have been identified in samples that contain predominantly cases with relapse-onset MS (ROMS). It is unknown whether the risk factors differ in people with a progressive-onset MS (POMS). Methods The case-control study included 147 POMS cases, 264 ROMS cases and 558 community controls. Questionnaires were used to collect information on smoking, infections, breastfeeding and vitamin use in early life. Logistic regression was used to examine associations. Odds ratios (ORs) were adjusted for age, sex and latitude band. Results Compared with controls, POMS cases were more likely to have smoked ≥20 pack-years (AOR 2.83, 1.53-5.24) and ROMS cases were more likely to have ever been a smoker (AOR 1.48, 1.09-2.01). POMS cases (AOR 1.75, 1.05-2.93) and ROMS cases (AOR 1.74, 1.21-2.49) were both more likely to have had infectious mononucleosis. In childhood, POMS cases were less likely to use vitamin supplements (AOR 0.52, 0.30-0.91) or being breastfed (AOR 0.49, 0.31-0.79). Conclusions Smoking and infectious mononucleosis are associated with increased risk of both POMS and ROMS. Vitamin supplements in early life and being breastfed are associated with reduced risk of POMS, but there is no association in ROMS. Key messages POMS and ROMS share some commonly known risk factors. Some protective factors were identified in POMS that were not observed in ROMS.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Sunil Kumar Shah ◽  
Dev Ram Sunuwar ◽  
Narendra Kumar Chaudhary ◽  
Pushpa Rai ◽  
Pranil Man Singh Pradhan ◽  
...  

Objectives. Gastric cancer (GC) is one of the most prevalent neoplasms and a leading cause of mortality globally. To our knowledge, its relationship with dietary factors is not adequately studied and understood in the Nepalese context. This study is aimed at exploring the relationship between the possible dietary risk factors responsible for gastric cancer in Nepal. Methods. A hospital-based matched case-control study was conducted in two specialized cancer hospitals in Nepal. A total of 237 participants (79 cases and 158 controls) were included in the study. Patients diagnosed within one year (incidence case) with histologically confirmed gastric cancer were taken as cases, and healthy visitors of gastric and nongastric cancer patients without past and present history or not a suspected information of gastric cancer were included as controls. A face-to-face interview was conducted using a semi-structured food frequency questionnaire. Backward stepwise conditional logistic regression was used to estimate the magnitude of the association between the independent variables and gastric cancer. Results were presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence intervals (CI). A P value < 0.05 was considered statistically significant. Results. In the adjusted multivariable conditional logistic regression model, an increased risk of gastric cancer was more likely to have higher odds among those respondents who had a high consumption of processed meat (AOR=3.99, 95% CI: 0.90-17.66), preferences of a high amount of fats/oil (AOR=4.64, 95% CI: 1.56-13.72), and preferences of high amounts of salts (AOR=4.18, 95% CI: 1.30-13.44). Conversely, those respondents who consumed higher amounts of fruits (AOR=0.21, 95% CI: 0.07-0.65) were seen to have lower odds of gastric cancer. Conclusions. Our study found an increased risk of gastric cancer with frequent consumption of red meat, processed meat, high preferences of salt, fats/oil, and condiments. Regular consumption of fruits had a protective effect against gastric cancer. Providing nutrition education, public awareness, and lifestyle modification are primary steps to promote the avoidance of risk factors and change unhealthy dietary habits to prevent gastric cancer in Nepal.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bülent Çomçalı ◽  
Servet Kocaoz ◽  
Buket Altun Özdemir ◽  
Ömer Parlak ◽  
Birol Korukluoğlu

AbstractThe aim of this study is to compare patients with and without mastalgia and to analyze the factors affecting mastalgia and its severity. The patient’s age, height, weight, educational status, marital status, and occupation were recorded in all subjects. In addition, the women were asked about the presence of any risk factors for mastalgia, such as tea and coffee consumption, smoking, alcohol consumption, and weight gain. The sternal notch to nipple distance (SNND) was measured to determine whether there was breast sagging. Mastalgia was significantly more common in women with BMIs of > 30 kg/m2 (OR: 2.94, CI 1.65–5.24), those who were primary school graduates or illiterate (OR: 2.96, CI 1.6–5.46), and those with SNND values of 22–25 cm (OR: 2.94, CI 1.79–4.82). In these women, drinking more than 6 cups of tea a day (OR: 2.15, CI 1.32–3.5), smoking at least 10 cigarettes a day (OR: 2.94, CI 1.78–4.83), and drinking alcohol at least once a week (OR: 2.1, CI 1.12–3.91) were found to be important factors that increased the risk of mastalgia. As a result, it has been found that severe mastalgia complaints cause by obesity, sagging breasts, never giving birth, unemployment anxiety, regular smoking, alcohol use, and excessive tea consumption.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Singh ◽  
S Gupta ◽  
T S Mishra ◽  
B D Banerjee ◽  
T Sharma ◽  
...  

Abstract Introduction Nephrolithiasis is pathological calcification in the excretory passages of the body and is prevalent among 7.6% of Indians. We aimed to study the various risk factors associated with renal stones from India. Method It was a hospital-based case-control study conducted over 18 months in a tertiary hospital in Delhi. Cases were defined as patients with renal stones diagnosed on the basis of history and radiological examination. Controls were similar to cases in all respects except for the diagnosis and selected from the hospital. A total of 18 risk factors, including age, gender, heavy metals, stress, metabolic factors, alcohol intake, dietary habits, co-morbidities, etc. were assessed. Logistic regression analysis was performed to calculate the strength of the risk associations. Results In the analysis of 60 cases and controls, we found 6 times, 5.5 times, and 2.4 times increased odds of renal stones in patients with increased arsenic, cadmium, and lead concentrations in blood, respectively. Similarly, there are 3 times increased odds of renal stones in patients suffering from stress. Conclusions Exposure to smoke, occupation dust, and contaminated water may lead to an increased ingestion/inhalation of heavy metals like cadmium, arsenic, and predisposing people to an increased risk of renal stones.


2021 ◽  
Vol 50 ◽  
pp. 102812
Author(s):  
Nuha M. Alkhawajah ◽  
Laith Hussain-Alkhateeb ◽  
Yafa A. Alshamlan ◽  
Mohammad Osama Almohaini ◽  
Ghadah A. Aleissa ◽  
...  

2020 ◽  
Vol 22 (1) ◽  
pp. 6-14
Author(s):  
Matthew I Hardman ◽  
◽  
S Chandralekha Kruthiventi ◽  
Michelle R Schmugge ◽  
Alexandre N Cavalcante ◽  
...  

OBJECTIVE: To determine patient and perioperative characteristics associated with unexpected postoperative clinical deterioration as determined for the need of a postoperative emergency response team (ERT) activation. DESIGN: Retrospective case–control study. SETTING: Tertiary academic hospital. PARTICIPANTS: Patients who underwent general anaesthesia discharged to regular wards between 1 January 2013 and 31 December 2015 and required ERT activation within 48 postoperative hours. Controls were matched based on age, sex and procedure. MAIN OUTCOME MEASURES: Baseline patient and perioperative characteristics were abstracted to develop a multiple logistic regression model to assess for potential associations for increased risk for postoperative ERT. RESULTS: Among 105 345 patients, 797 had ERT calls, with a rate of 7.6 (95% CI, 7.1–8.1) calls per 1000 anaesthetics (0.76%). Multiple logistic regression analysis showed the following risk factors for postoperative ERT: cardiovascular disease (odds ratio [OR], 1.61; 95% CI, 1.18–2.18), neurological disease (OR, 1.57; 95% CI, 1.11–2.22), preoperative gabapentin (OR, 1.60; 95% CI, 1.17–2.20), longer surgical duration (OR, 1.06; 95% CI, 1.02–1.11, per 30 min), emergency procedure (OR, 1.54; 95% CI, 1.09–2.18), and intraoperative use of colloids (OR, 1.50; 95% CI, 1.17–1.92). Compared with control participants, ERT patients had a longer hospital stay, a higher rate of admissions to critical care (55.5%), increased postoperative complications, and a higher 30-day mortality rate (OR, 3.36; 95% CI, 1.73–6.54). CONCLUSION: We identified several patient and procedural characteristics associated with increased likelihood of postoperative ERT activation. ERT intervention is a marker for increased rates of postoperative complications and death.


2009 ◽  
Vol 67 (2a) ◽  
pp. 229-234 ◽  
Author(s):  
Kátia Regina Penha da Silva ◽  
Regina Maria Papais Alvarenga ◽  
Oscar Fernandez y Fernandez ◽  
Hélcio Alvarenga ◽  
Luiz Claudio Santos Thuler

PURPOSE: To evaluate potential risk factors for the development of multiple sclerosis in Brazilian patients. METHOD: A case control study was carried out in 81 patients enrolled at the Department of Neurology of the Hospital da Lagoa in Rio de Janeiro, and 81 paired controls. A standardized questionnaire on demographic, social and cultural variables, and medical and family history was used. Statistical analysis was performed using descriptive statistics and conditional logistic regression models with the SPSS for Windows software program. RESULTS: Having standard vaccinations (vaccinations specified by the Brazilian government) (OR=16.2; 95% CI=2.3-115.2), smoking (OR=7.6; 95% CI=2.1-28.2), being single (OR=4.7; 95% CI=1.4-15.6) and eating animal brain (OR=3.4; 95% CI=1.2-9.8) increased the risk of developing MS. CONCLUSIONS: RESULTS of this study may contribute towards better awareness of the epidemiological characteristics of Brazilian patients with multiple sclerosis.


2019 ◽  
Author(s):  
Helda Tutunchi ◽  
Maryam Saghafi-Asl ◽  
Mohammad Asghari-Jafarabadi ◽  
Alireza Ostadrahimi

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is an important public health problem and a significant cause of morbidity and mortality. Little is known about the relation between food insecurity and NAFLD. This study aimed to assess the relationship between food insecurity, risk factors associated with food insecurity, and NAFLD prevalence in a sample of Iranian adults.Methods In this age-matched and gender-matched case–control study, 210 subjects were recruited. NAFLD diagnosis was performed by a single expert radiologist using ultrasonography. The demographic and socioeconomic characteristics, anthropometric indices, body composition, along with food insecurity and depression status were assessed. Blood samples were collected to determine the lipid profile parameters. Chi-square, independent samples t-test, and uni-and multi-variate logistic regression tests were used. Data were analysed using SPSS V.23.0.Results The prevalence of food insecurity was 56.8% and 26.1% in cases and controls ( P<0.001 ), respectively. According to final analysis model, food insecurity, depression, number of children≥4, overweight, and obesity were identified as significant independent risk factors for NAFLD. The chance of NAFLD in the food insecure, depressed, overweight, and obese subjects was 2.2 (95%CI:1.12-3.43), 1.9 (95%CI:1.02-3.62), 2.6 (95% CI:1.81-3.92), and 2.9 (95%CI:2.02- 5.34) times higher, respectively. Additionally, a higher waist circumference (men, OR = 2.9, P<0.001 ; women, OR= 2.6, P<0.001 ), an elevated waist-to-hip ratio (men, OR = 2.3, P<0.001 ; women, OR= 2.7, P<0.001 ), an increased waist-to-height ratio (OR = 2.9, P<0.001 ), and a higher body fat percentage (men, OR = 3.0, P<0.001 ; women, OR= 3.3, P<0.001 ) were independently associated with an increased risk of NAFLD. The odds of NAFLD increased by increment in serum triglyceride (TG) levels (OR = 2.6, P<0.001 ) and decreased by increase in serum high-density lipoprotein cholesterol (HDL-C) (OR = 0.34, P<0.001 ). Compared to controls, NAFLD patients were more likely to have higher TG/HDL-C ratio (OR = 3.3, P<0.001 ).Conclusions The prevalence of food insecurity in patients with NAFLD was significantly higher compared to controls. Food insecurity was associated with an increased risk of NAFLD, even after adjusting for potential confounding factors. Additionally, NAFLD was significantly related to some indicators of dyslipidemia.


2020 ◽  
Author(s):  
Helda Tutunchi ◽  
Maryam Saghafi-Asl ◽  
Mohammad-Javad Hosseinzadeh Attar ◽  
Mohammad Asghari-Jafarabadi ◽  
Alireza Ostadrahimi

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is an important public health problem and a significant cause of morbidity and mortality. Little is known about the relation between food insecurity and NAFLD. This study aimed to assess the relationship between food insecurity, risk factors associated with food insecurity, and NAFLD prevalence in a sample of Iranian adults.Methods In this age-matched and gender-matched case–control study, 210 subjects were recruited. NAFLD diagnosis was performed by a single expert radiologist using ultrasonography. The demographic and socioeconomic characteristics, anthropometric indices, body composition, along with food insecurity and depression status were assessed. Blood samples were collected to determine the lipid profile parameters. Chi-square, independent samples t-test, and uni-and multi-variate logistic regression tests were used. Data were analysed using SPSS V.23.0.Results The prevalence of food insecurity was 56.8% and 26.1% in cases and controls ( P<0.001 ), respectively. According to final analysis model, food insecurity, depression, number of children ≥ 4, overweight, and obesity were identified as significant independent risk factors for NAFLD. The chance of NAFLD in the food insecure, depressed, overweight, and obese subjects was 2.2 (95%CI: 1.12-3.43), 1.9 (95%CI: 1.02-3.62), 2.6 (95%CI: 1.81-3.92), and 2.9 (95%CI: 2.02- 5.34) times higher, respectively. Additionally, a higher waist circumference (men, OR = 2.9, P < 0.001 ; women, OR= 2.6, P< 0.001 ), an elevated waist-to-hip ratio (men, OR=2.3, P<0.001 ; women, OR=2.7, P<0.001 ), an increased waist-to-height ratio (OR=2.9, P<0.001 ), and a higher body fat percentage (men, OR=3.0, P<0.001 ; women, OR=3.3, P<0.001 ) were independently associated with an increased risk of NAFLD. The odds of NAFLD increased by increment in serum triglyceride (TG) levels (OR=2.6, P<0.001 ) and decreased by increase in serum high-density lipoprotein cholesterol (HDL-C) (OR=0.34, P<0.001 ). Compared to controls, NAFLD patients were more likely to have higher TG/HDL-C ratio (OR =3.3, P<0.001 ).Conclusions The prevalence of food insecurity in patients with NAFLD was significantly higher compared to controls. Food insecurity was associated with an increased risk of NAFLD, even after adjusting for potential confounding factors. Additionally, NAFLD was significantly related to some indicators of dyslipidemia.


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