BACKGROUNDAlthough epidemiological studies have persistently shown a high prevalence of diabetes in Arabs, the control of diabetes is still poor and complications of diabetes are common. We examined the prevalence of diabetic peripheral neuropathy (DN), neuropathic foot ulceration (FU) and peripheral vascular disease (PVD), and potential risk factors for these complications among patients attending primary care diabetes clinics in Bahrain.PATIENTS AND METHODSWe studied 1477 diabetic patients (Type 2 diabetes 93%); to, including 635 men and 842 women, with ages ranging from 18–75 years in a cross-sectional study. The main predictor variables were demographic and clinical data, including assessment of foot and blood parameters.RESULTSMean age of the patients and duration of diabetes were 57.3±6.32 and 9.5±8.4 years, respectively. DN was present in 36.6% of the population, FU in 5.9%, and PVD in 11.8%. Diabetic patients with neuropathy were older than patients without neuropathy (P=0.001) and had had diabetes longer (P=0.002). Diabetic patients with foot ulcers had more severe neuropathy and higher vibration perception thresholds values than patients without foot ulcers (P<0.05). Older age, poor glycemic control, longer duration of diabetes, elevated cholesterol levels, current smoking, obesity defined by body mass index, large waist circumference, elevated triglycerides levels and hypertension but not gender, were significant risk factors for DN in both the univariate and the multivariate analyses (P< 0.05). DN and PVD also remained significant risk factors for foot ulceration in the multiple logistic regression analysis.CONCLUSIONRates of DN and PVD are high among diabetic patients in Bahrain. Implementation of strategies for prevention, early detection, and appropriate treatment at the primary health care level are urgently needed.

BackgroundChanges in dietary habits and lifestyle are considered the main factors associated with several diet-related diseases in the Arab Gulf countries. The aim of this study was, therefore, to describe the dietary and lifestyle habits amongst adolescents in Bahrain.DesignA cross-sectional study was carried out amongst male and female secondary school students selected using the multi-stage stratified random sampling technique. A sample size of 735 subjects (339 males and 396 females), aged 15–18 years, was selected from government schools from all the governorates of Bahrain.ResultsSkipping breakfast was significantly greater in females (62.8%) compared to males (37.2%), (P<0.01). About 88% of adolescents snacked during school break, 70.7% procuring food from the school canteen. Fruit was not consumed by about 27.7% of respondents (33.5% males, 66.5% females) and the gender difference was statistically significant (P<0.01). Fish and lentils were less preferred, while chicken was more popular. There was no significant difference between gender and frequency of eating fast food. About 8.4% of respondents reported not eating burgers, with 68.8% preferring regular size burgers. Furthermore, 24.4% preferred large portions of potato chips (53.1% male, 46.9% female). About 29.8% watched TV for more than 5 hours a day (51.2% females, 48.8% males). About 69% of males practiced sports everyday as against 30.8% of females (P<0.01) and 81.6% of those who participated in sport activity outside school were males compared to 18.4% of females.ConclusionIt seems that the adolescents in Bahrain are moving toward unhealthy dietary habits and lifestyles, which in turn will affect their health status in the future. Promoting healthy lifestyle and eating habits should be given a priority in school health programs.

Aims To determine whether a particular anticonvulsant is more effective or safer than another or placebo in patients with status epilepticus, and to summarize the available evidence from randomized controlled trials, and to highlight areas for future research in status epilepticus. Methods Randomized controlled trials of participants with premonitory, early, established or refractory status epilepticus using a truly random or quasi‐random allocation of treatments were included. Results Eleven studies with 2017 participants met the inclusion criteria. Lorazepam was better than diazepam for reducing risk of seizure continuation [relative risk (RR) 0.64, 95% confidence interval (CI) 0.45, 0.90] and of requirement of a different drug or general anaesthesia (RR 0.63, 95% CI 0.45, 0.88) with no statistically significant difference in the risk of adverse effects. Lorazepam was better than phenytoin for risk of seizure continuation (RR 0.62, 95% CI 0.45, 0.86). Diazepam 30 mg intrarectal gel was better than 20 mg in premonitory status epilepticus for the risk of seizure continuation (RR 0.39, 95% CI 0.18, 0.86). Conclusions Lorazepam is better than diazepam or phenytoin alone for cessation of seizures and carries a lower risk of continuation of status epilepticus requiring a different drug or general anaesthesia. Both lorazepam and diazepam are better than placebo for the same outcomes. In the treatment of premonitory seizures, diazepam 30 mg intrarectal gel is better than 20 mg for cessation of seizures without a statistically significant increase in adverse effects. Universally accepted definitions of premonitory, early, established and refractory status epilepticus are required.

No abstract

Background:In the populations of the Arabian Peninsula, obesity has emerged as the leading cause of morbidity and mortality over a 25-year period of swift socioeconomic progress. The objective of this study was to determine the body weight distribution, prevalence and risk factors for the overweight and obese in the native adult Bahraini population. Subjects and Methods A cross-sectional national epidemiological community survey was conducted involving 2013 Bahraini subjects aged 40-69. The males were aged 40-59 years, with a mean age of 49 years, while the females were aged 50-69 years, with a mean age of 59. The sample was adjusted for gender, age, and area of residence distribution. A questionnaire describing the demographic, social, educational status and income status was completed. Measurements were made of height and weight, and body mass index (BMI) was calculated for each subject. WHO classification was used for defining overweight (BMI 25-29.9 kg/m

Intravenous lorazepam is better than intravenous diazepam or intravenous phenytoin alone for cessation of seizures. Intravenous lorazepam also carries a lower risk of continuation of status epilepticus requiring a different drug or general anaesthesia compared with intravenous diazepam. Both intravenous lorazepam and diazepam are better than placebo for the same outcomes. For pre hospital management, midazolam IM seemed more effective than lorazepam IV for cessation of seizures, frequency of hospitalisation and ICU admissions however,it was unclear whether the risk of recurrence of seizures differed between treatments. The results of other comparisons of anticonvulsant therapies versus each other were also uncertain. Universally accepted definitions of premonitory, early, established and refractory status epilepticus are required. Diazepam gel was better than placebo gel in reducing the risk of non-cessation of seizures. Results for other comparisons of anticonvulsant therapies were uncertain due to single studies with few participants.

BACKGROUNDAlthough epidemiological studies have persistently shown a high prevalence of diabetes in Arabs, the control of diabetes is still poor and complications of diabetes are common. We examined the prevalence of diabetic peripheral neuropathy (DN), neuropathic foot ulceration (FU) and peripheral vascular disease (PVD), and potential risk factors for these complications among patients attending primary care diabetes clinics in Bahrain.PATIENTS AND METHODSWe studied 1477 diabetic patients (Type 2 diabetes 93%); to, including 635 men and 842 women, with ages ranging from 18–75 years in a cross-sectional study. The main predictor variables were demographic and clinical data, including assessment of foot and blood parameters.RESULTSMean age of the patients and duration of diabetes were 57.3±6.32 and 9.5±8.4 years, respectively. DN was present in 36.6% of the population, FU in 5.9%, and PVD in 11.8%. Diabetic patients with neuropathy were older than patients without neuropathy (P=0.001) and had had diabetes longer (P=0.002). Diabetic patients with foot ulcers had more severe neuropathy and higher vibration perception thresholds values than patients without foot ulcers (P<0.05). Older age, poor glycemic control, longer duration of diabetes, elevated cholesterol levels, current smoking, obesity defined by body mass index, large waist circumference, elevated triglycerides levels and hypertension but not gender, were significant risk factors for DN in both the univariate and the multivariate analyses (P< 0.05). DN and PVD also remained significant risk factors for foot ulceration in the multiple logistic regression analysis.CONCLUSIONRates of DN and PVD are high among diabetic patients in Bahrain. Implementation of strategies for prevention, early detection, and appropriate treatment at the primary health care level are urgently needed.

Obesity greatly increases the risks of developing diseases, including diabetes mellitus, hypertension, dyslipidaemia, coronary artery disease, and some cancers. At least one-third of Arabs are obese, as defined by body mass index (BMI) more than 30 kg/m2 and this figure is rising steadily despite increased interest in fitness. Women have particularly high rates of obesity. Obesity is clearly associated with increased risk for mortality, but there has been controversy regarding optimal weight with respect to mortality risk. A review of recent studies on the prevalence of obesity among population of the Arabian Peninsula and the evaluation of the health risk of obesity is presented in this paper. The prevalence of obesity ranges between 16-25% in men and 17-43% in women. The most prevalent chronic diseases related to obesity in these populations are diabetes, hypertension and coronary heart disease (CHD).