BackgroundGilbert syndrome (GS) is an autosomal recessive inherited disorder of bilirubin glucuronidation which has not been investigated in Egypt. This longitudinal study investigated the frequency, clinical course, genetic profile and health related quality of life in Egyptian adults.MethodsAn initial cross-sectional study was conducted to assess the frequency of Gilbert syndrome among Egyptian adults. Subjects fulfilling the criteria of GS were enrolled into the study and prospectively followed for the clinical features, risk factors for hyperbilirubinemia, health related quality of life [Short form-36 Health Survey version 2 (SF-36v2) and Chronic Liver Disease Questionnaire (CLDQ)], vitamins assessment and UGT1A1 polymorphisms.ResultsOne hundred and one subjects fulfilled the criteria of GS with a prevalence of 8.016%. Recurrent jaundice was the only presentation in 47 (56.627%) GS subjects and jaundice was associated with abdominal pain, dyspepsia or loss of appetite in 54 (53.465%) subjects. A significant difference in 25-Hydroxyvitamin D3 levels was detected between GS patients and control subjects (P <  00001). Twelve subjects with GS developed significant unconjugated bilirubinemia during direct antiviral therapy (DAAs) therapy for HCV despite achieving sustained virologic response. Pregnancy was associated with significant exacerbation of unconjugated bilirubin which persisted through pregnancy. Risk factors for clinical jaundice included general anesthesia, pregnancy, fasting > 12 h, pregnancy, and low calorie weight losing plans, systemic infections, and intensive physical effort. During jaundice attacks, subjects with GS had significant differences in vitality, role emotional, social functioning, worry and general health domains of the SF-36v2 and CLDQ compared to controls. The homozygous polymorphism A(TA)7TAA was the most frequent polymorphism in Egyptians with GS.ConclusionGilbert syndrome is a frequent inherited disorder in Egypt. In a substantial percentage of subjects with GS, episodes of jaundice are associated with other symptoms and nutritional deficiencies which result in impairment of HRQOL. Screening, counseling, monitoring and individualized health care are recommended for subjects with GS in the setting of anesthesia, pregnancy, treatment with DAAs, deliveries, surgery and weight loss plans.

Background Cyberbullying is a modern form of bullying that could be practiced electronically or on the internet. It is related to different mental health issues such as depression, which can affect both the cyberbully and the victim. Although a few studies have been conducted regarding the prevalence of cyberbullying and cyber-victimization among the younger generation in Qatar, no studies have been conducted among young adults despite studies showing that they are also prone to cyberbullying. Methods This is a cross-sectional study to investigate the prevalence and the relationship between cyberbullying, cyber-victimization, and depression symptoms among Qatar University students. A self-administered close-ended electronic questionnaire was used to assess student’s cyberbullying/cyber-victimization behaviors and depression symptoms. The Revised Cyberbullying Inventory scale (RCBI-II) and Patient Health questionnaire-9 (PHQ-9) were utilized to measure involvement in cyberbullying and depression symptoms, respectively. A total of 836 students participated in the study. Pearson Chi-Square test and binary logistic regression were conducted to analyze the data. Results Results indicated the majority of students have been involved in cyberbullying as follows: 6.8% cyberbullies, 29.2% cybervictims, 35.8% cyberbully-victims, and 28.2% not involved in either. Approximately 50% of the students scored a ten or higher on the PHQ9 test indicating symptoms of depression. Moreover, significant associations were found between cyberbullying experiences and gender (p = 0.03), depression and gender (p = 0.046), and between cyberbullying experiences and depression (p<0.001). Conclusion Our findings indicate that among Qatar University students, cyberbullying and cyber-victimization are prevalent behaviors that could be associated with the high reported rates of depression symptoms.

Background & Aims: Sickle cell disease (SCD has a worldwide distribution and causes significant morbidity and mortality in children and adults. Few studies addressed the determinants of SCD severity in adults; therefore, we investigated the impact of nutrition on the outcome of SCD and health-related quality of life (HRQoL) in adult patients, Methods: In this longitudinal study, we recruited and prospectively followed 62 adults with SCD  (aged ?18 years) for a  median of 93 months. At entry and follow-up, patients provided medical and dietary history,  had a physical examination and anthropometric measurements, assessment of protein-energy intake, measurement of micronutrient levels, estimation of  SCD severity score, and determination of the HRQoL  (SF-26v2). The study outcome was a composite of hospitalization due to SCD crises or death. Results: At baseline, 42 (67.74%) patients had macro and, or micro-undernutrition (Group A), and 20 (32.26%) were well nourished. (Group B).  The   BMI and most anthropometric measurements were significantly lower in SCD patients compared to control subjects.  In several SCD patients, undernutrition resulted from reduced food intake and reduced absorption due to concomitant gastrointestinal disorders. Seventy percent of  SCD patients had vitamin D,  vitamin B12, and zinc deficiencies. Under-nourished patients had significantly higher SCD severity scores, frequent SCD related hospitalizations, higher mortality rates, and reduced HRQoL compared to well-nourished patients.  Protein-energy and micronutrient deficiencies were independent predictors of severe SCD and mortality. Correction of undernutrition and hydroxyurea therapy improved SCD severity scores and HRQoL. Conclusion: Patients with sickle cell disease have various degrees of macro and micro deficiencies, which increase SCD severity and hospitalizations and reduce the health-related quality of life. Early diagnosis and prompt correction of macro and micronutrient deficiencies need to be incorporated in the standard of care of SCD patients to improve the disease outcomes.