The overall knowledge and attitudes of Jordanians towards epilepsy is relatively comparable with the results from Asian countries but more negative when compared with reports from the Western countries. Consequently, well-organized educational campaigns are needed to improve public perception about epilepsy.

Aim The aim of this investigation was to explore the correlation of shisha smoking with blood pressure and heart rate values. Subjects and methods This is a randomized cross-sectional epidemiological study involving a total of 14,310 adults selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in outpatient settings. The frequencies of water-pipe-smoking males and females in the sample were 21.11% and 10.27%, respectively. Measures of blood pressure and heart rate values were carried out in outpatient settings. For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured three times with 10-15-min intervals in the sitting position and at the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP. Results Smokers had significantly higher blood pressure and heart rate values than non-smokers. Both smokers and non-smokers with a positive family history of hypertension had significantly higher values of blood pressure than those with a negative family history. Conclusion A significant elevation of blood pressure and heart rate was observed among shisha smokers. Current cigarette smoking associated with frequent water pipe smoking resulted in greater elevation in blood pressure measurements among both types of tobacco smokers.

Diabetes mellitus is the most common metabolic disorder worldwide. To date, there have been no reports on the frequency of use of herb medicines in the managements of diabetes mellitus in Jordan. This cross-sectional study was conducted by interviewing 310 diabetic patients visiting two medical centers in Jordan: Jordan University of Science & Technology Medical Center and Sarih Medical Center between December 2003 and August 2004. It is found that 31% of interviewed patients have used herbal products (96 patients). The results revealed that the most commonly used herbs by diabetic patients in Jordan were Trigonella foenumgraecum (22.9%), Lupinus albus (14.6%), Allium sativum (11.5%), Allium cepa (5.2%), Nigella sativa (7.3%), Zea mays L. (6.3%), Urtica dioica L. (8.3%), Eucalyptus globules LA (9.4%), Olea europea L. (3.1%), Cumminum cyminum (9.4%), Coriandrum sativum (10.4%), Salvia officinalis L. (3.1%), and Tilia cordata (1%). Furthermore, it is found that 47.9% of the patients used herbs according to advice from their friends on a daily basis. The side effects were reported by 36.5% of the patients and include headache, nausea, dizziness, itching, palpitation, and sweating. Among the patients, 72.9% used the herbs as adjunctive therapy along with their anti-diabetic drugs and 80.2% of the patients informed their physicians about their use. A 79.2% of the sample confirmed their intention to re-use these herbs as 86.5% of them were satisfied with their diabetes control. There was a significant relationship between the use of herbs, the patient's place of residence and his/her level of education. The main conclusion of this survey is that the use of medicinal herbs among diabetic patient in Jordan is common. Therefore, it is essential to increase the level of awareness among diabetic patients and health care providers regarding the efficacy and toxicity of these medicinal herbs.

Background-Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. Methods and Results-Data on 141 317 participants (62 666 never, 40 669 former, 37 982 current smokers) from 23 population-based studies were included in observational and Mendelian randomization meta-analyses of the associations of smoking status and smoking heaviness with systolic and diastolic blood pressure, hypertension, and resting heart rate. For the Mendelian randomization analyses, a genetic variant rs16969968/rs1051730 was used as a proxy for smoking heaviness in current smokers. In observational analyses, current as compared with never smoking was associated with lower systolic blood pressure and diastolic blood pressure and lower hypertension risk, but with higher resting heart rate. In observational analyses among current smokers, 1 cigarette/day higher level of smoking heaviness was associated with higher (0.21 bpm; 95% confidence interval 0.19; 0.24) resting heart rate and slightly higher diastolic blood pressure (0.05 mm Hg; 95% confidence interval 0.02; 0.08) and systolic blood pressure (0.08 mm Hg; 95% confidence interval 0.03; 0.13). However, in Mendelian randomization analyses among current smokers, although each smoking increasing allele of rs16969968/rs1051730 was associated with higher resting heart rate (0.36 bpm/allele; 95% confidence interval 0.18; 0.54), there was no strong association with diastolic blood pressure, systolic blood pressure, or hypertension. This would suggest a 7 bpm higher heart rate in those who smoke 20 cigarettes/day. Conclusions-This Mendelian randomization meta-analysis supports a causal association of smoking heaviness with higher level of resting heart rate, but not with blood pressure. These findings suggest that part of the cardiovascular risk of smoking may operate through increasing resting heart rate. Key Words: blood pressure ◼ heart rate ◼ hypertension ◼ Mendelian randomization ◼ smoking S moking is a major risk factor for cardiovascular disease, but it is not clear by which mechanism smoking exerts its detrimental effects on cardiovascular disease. Generally, epidemiological studies have reported lower blood pressure levels among current smokers compared with nonsmokers. 1-14 On the contrary, smoking cessation has been reported to be followed by a decrease in blood pressure. 15,16 Whether the apparent association between smoking and lower blood pressure is causal or can be explained by confounding by lifestyle or socioeconomic factors related to both smoking and blood pressure remains an open question. Furthermore, smoking is causally associated with lower body mass index (BMI), 17 and higher level of adiposity is strongly associated with elevated blood pressure and is also considered a major risk factor for hypertension. 18,19 Hence, there is a strong possibility that the lower blood pressure observed in smokers could be explained by lower body weight caused by smoking. Data from observational epidemiological...

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