The hidden danger in Syria: Silent Celiac Disease

Celiac disease (CD) is a disorder caused by an aberrant autoimmune response to gluten ingestion in genetically susceptible individuals. Its prevalence nears 1%, and it is not considered typical in the Middle East because of the lack of reports in the Arabic countries. Therefore, this study aimed to define the prevalence of celiac disease in the Syrian community. Healthy young adults and volunteers ranging between 5–65-year-old were tested from December 2018 till May 2019. Samples from the participant's sera were tested for anti-tissue transglutaminase antibody (tTG) IgA/IgG by ELISA using the human recombinant transglutaminase antigen. One hundred participants with a mean ± SD of 22 ± 14 years-old were recruited in the study. Only one participant was suspected of having celiac disease. The mean ± SD of anti-tTG IgA/IgG values were 9.81 ± 9.61 for IgA and 6.64 ± 6.60 for IgG. The study shows no significant difference in IgA or IgG titers between males and females at P = 0.7, P = 0.8, respectively. The estimation of seroprevalence of CD antibodies in a healthy Syrian population is close to 1%. We suggest that the underdiagnosed CD might pose a high risk in Syria, contrary to previous thoughts.

Evaluation of Corneal Higher- Order Aberrations in Adults with Different Refractive Status: تقييم الزّوغانات القرنيّة عالية التّرتيب عند البالغين في مختلف الحالات الانكساريّة

Purpose: The aim of this study is to evaluate the root mean square error (RMS) of corneal higher- order aberrations in Syrian adult population in different refractive status (emmetropia, myopia, hyperopia and simple myopic astigmatism). Methods: This cross- sectional study was conducted at Tishreen University Hospital in Latakia, Syrian Arab Republic. A total of 420 patients (840 eyes), ages 18- 40 years, participated in the study. Refraction was measured with an autorefractor keratometer and expressed as a spherical equivalent. Total corneal higher- order aberrations (Coma, Spherical Aberration, Trefoil) were measured using Sirius Corneal Topography at a pupil diameter of 5 mm. Results: RMS of Coma and Spherical aberrations peaked in the hyperopia group (0.18 ± 0.08, 0.11 ± 0.02) respectively. Whereas, Trefoil was higher in the severe myopia and simple myopic astigmatism groups (0.25 ± 0.05, 0.25 ± 0.08) respectively. Conclusions: Among a Syrian population, some types of refractive status were associated with certain types of higher- order aberrations, with a significant increase in trefoil in severe myopia and simple myopic astigmatism.

The situation of Syrian Christians in the context of the Arab Spring events

The article is based on the information published in foreign and Russian sources and media, as well as on the basis of the authors own research and interviews carried out in Syria. The aim of the work is to study the situation of Syrian Christians after the events of the Arab Spring-2011. This is the scientific novelty of the topic. The article is devoted to the problems that not only touched, but most dramatically affected the life of Christians in Syria, who traditionally presented at least 12% of its population (and much more in the past). They are representatives of the most indigenous religion in the Syrian Arab Republic (SAR). The work also traces the role of Christians in the history and socio-political life of Syria, analyzes their current situation, evaluates the events of recent years and draws appropriate conclusions. In particular, the author believes that the Arab Spring led not only to huge human and economic losses, but also to serious ethno-confessional structural changes in the society of the SAR. With the possible disappearance of this native part of the Syrian population, who lived here and represented almost all the inhabitants of that region before the Islam, the republic may lose not only 12 percent of the most educated and active part of its population, but also its tourist attractiveness in the eyes of the whole world. Although Syria has always been considered the cradle of Christianity it could lose its reputation as one of the most tolerant countries of the Arab world.

Hambatan PBB dalam Merespon Mass Atrocity di Suriah pada Tahun 2011-2013

The Syrian conflict is one of the deadliest conflicts that occurred as a result of the Arab Spring. A large number of casualties in this conflict shows how sovereign state and international community had failed to fulfill their responsibility to protect civilians from mass atrocities. The purpose of this article is to examine what obstacles the United Nations had faced in its effort to protect the Syrian population. The framework that used to analyze this issue is the concept of Global Governance and the Responsibility to Protect. Using descriptive qualitative research methods, data will be collected from books, journal articles, official reports and media publications to explain four obstacles United Nations had faced. The first obstacle related to growing multipolarity that causes difficulty in reaching a consensus during the negotiations. The second obstacle related to UN Security Council permanent member dysfunctional behavior which often causes a deadlock in decision making. The third obstacle is the complexity of the conflict that occurred. The last one is the differences opinion among related organizations that relieves the international pressure to immediately end the mass atrocities.

Pharmacogenetics: Knowledge assessment amongst Syrian pharmacists and physicians

Background Pharmacogenetics targets genetic variations that influence drug response. It is relatively a new science that has not been vastly employed in most developing countries including Syria. Therefore we aimed at evaluating the depth of knowledge in pharmacogenetics and the attitude towards it amongst Syrian pharmacists and physicians. Methods We carried out an internet-based questionnaire consisted of 26 questions, sent through specialized websites and private groups with a large number of pharmacists and physicians members. The survey was available online for a period of 1 month. Results The total number of respondents was 154, mostly female pharmacists. Our statistical analysis showed a strong positive association between profession (in favour of pharmacists) and pharmacogenetics knowledge p = 0.049; however, no correlation with experience p = 0.811 was found. A significant difference was reported between the knowledge of pharmacists and physicians p = 0.001 concerning drugs that need pharmacogenetics testing before being prescribed. The majority of respondents had no information about applying genetic tests in Syria before prescribing medications nor did they possess the knowledge regarding drugs that show differential responses in patients according to their unique genotypes. In our study, the percentage knowledge assessment score was low in general (mean ± Standard deviation, SD) (46% ± 13.9%). The majority of the respondents agreed that pharmacists should provide counselling to patients on the subject of pharmacogenetics. Respondents’ opinions varied concerning making pharmacogenetics learning a priority. Conclusion Lack of pharmacogenetics knowledge was found amongst respondents in general. Our findings raise concerns about the lack of awareness amongst physicians, which may hinder the implementation of this crucial field in Syria. We suggest an emphasis on the role of education, training, and conducting genotyping research on the Syrian population.

Central Corneal Thickness of Syrian Population in Relation to Different Parameters: ثخانة القرنية المركزية لِعيّنة من المواطنين السورييّن وعلاقتها مع المتغيّرات المختلفة

Objectives: The aim of this study is to determine the mean Central Corneal Thickness (CCT) among a normal Syrian population and to correlate between Central Corneal Thickness and age, gender and axial length. Methods: This study was carried out at Tishreen University Hospital in Latakia. A total of 516 eyes from 258 individuals with an age range from 18 to 56 years were studied. Central Corneal Thickness was measured using corneal topography (SIRIUS). Axial length was measured using contact ultrasound A-scan (AVISO). Results: The mean CCT was 546.7±31.2 µm with a range from 456 to 643 µm. CCT was not affected by gender. CCT significantly negatively correlated with age (p=0.001). There was no statistically significant correlation between CCT and axial length (p=0.6). Conclusions: CCT varies according to race. Among a Syrian population, CCT significantly decreased with age.

Prevalence of Anti HBC Antibodies in Blood Donors from Different Centers in Lebanon

Background: Hepatitis B virus (HBV) is a major cause of the liver disease that could lead to acute and chronic inflammation of the liver. In this study we collected anti HBC antibodies (anti hepatitis B core) results done as screening of blood donors from three hospital centers in Lebanon between Jan.2016to Jan.2019. The aim of this study is to collect epidemiological data on the prevalence of positive anti HBC antibodies in blood donors of different nationalities. Method: Blood donation records from the three hospitals were collected from Jan. 2016 till Jan. 2019 and they included 16000 volunteers for blood donation and all these donors were tested for anti HBC antibodies. Results: The total number of donors was 16000, 1224 volunteers (7.65%) had positive anti HBC test. The prevalence of anti HBC antibodies was higher in Syrian population with a prevalence of 12.9% as compared to the Lebanese donors with prevalence of 6.6%. Age was found to have a statistically significant relationship with the prevalence of hepatitis B. blood group was found not to have a statistically significant relationship with hepatitis B.

Public health consequences after ten years of the Syrian crisis: a literature review

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID − 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.

Iranian Reconstruction, Development, and Aid in Syria

This article examines the activities of the Iranian parastatal development organization Construction Jihad in the Syrian Civil War since 2015. Construction Jihad has implemented reconstruction and development projects and delivered social services and humanitarian aid in order to appease segments of the Syrian population and help pro-government forces consolidate territory. This case study sheds light on the complexities and tensions surrounding the Syrian regime's alliance with Iran and Russia and its efforts to preserve national sovereignty and avoid becoming dependent on its allies.