Laryngopharyngeal reflux in war-torn Syria and its association with smoking and other risks: an online cross-sectional population study

Kakaje, Ameer; Alhalabi, Mohammad Marwan; Alyousbashi, Ayham; Hamid, Aya; Mahmoud, Yousef

doi:10.1136/bmjopen-2020-041183

Cited by 10 publications

(9 citation statements)

References 32 publications

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“…Another study found that around 50% of the population had allergic rhinitis which could be from the direct or indirect effects of war or the unique environment [ 47 ]. A similar study found a high prevalence of laryngopharyngeal reflux which is also related to war variables [ 48 ]. Smoking is also common among the Syrian population, mainly social shisha smoking which could be to get away from the daily stress.…”

Section: Discussionmentioning

confidence: 99%

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

et al. 2021

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Background Syria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees. Methods This is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors. Results Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores. Conclusion The conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.

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Section: Discussionmentioning

confidence: 99%

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

et al. 2021

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“…Finally, high educational level included having a university degree or higher. This system is used in Syria as these groups have distinguished features, and it was used previously in many studies [ 26 , 27 , 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

Interactions of Consanguinity and Number of Siblings with Childhood Acute Lymphoblastic Leukemia

Kakaje

Alhalabi

Ghareeb

et al. 2020

BioMed Research International

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Acute lymphoblastic leukemia (ALL) is a common malignancy in children. Consanguinity has a high prevalence in developing countries and increases the probability of homozygosity for many genes which may affect ALL and its prognosis. We conducted a study to explore the impact of consanguinity and number of siblings on ALL as there are currently no studies to describe this effect. Data were collected from patients’ records from the Children’s University Hospital of Damascus University, which is the major cancer centre for children in Syria. This study included 193 children with ALL over one year. Number of siblings was not with the French–American–British (FAB) classification, gender, ALL subtype, or risk of ALL children. When comparing consanguinity degrees and complete blood counts at diagnosis, significant contradicting data were found in the third-degree and fourth-degree consanguinity when compared to one another and to not having consanguineous parents as third degree consanguinity was associated with normal platelets but lower WBC counts, and fourth-degree consanguinity was associated with normal haemoglobin levels and WBC counts, but lower platelet counts. Having consanguineous parents was also associated with acquiring ALL at an older age, L2 FAB classification, having a positive family history for malignancies, and not having hepatosplenomegaly ( P < 0.05 ). Although L2 is known to be a poor prognosis indicatory, no association was found with consanguinity and risk. Finally, no association was found with ALL subtype or risk ( P > 0.05 ). Although consanguinity and number of siblings have affected some variables and prognostic features of childhood ALL, the aetiology is not clear and we need further studies to clarify such an association as this will help in optimising therapy and accurately determine the risk.

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“…AR and allergic laryngitis (AL) can have similar manifestations 32 . Epigastric burning sensation, chest pain, and indigestion were the most common symptoms of LPR in Syria while having a sore throat was the least common 4 . AR symptoms can include sneezing, nasal itching, rhinorrhoea, and congestion 19 , 20 .…”

Section: Discussionmentioning

confidence: 99%

“…In Syria, LPR had a prevalence of 31.9% and AR had a prevalence of 47.9%. They were both associated with asthma, allergies, distress from war, and smoking 4 , 13 . Moreover, 61.2% of Syrians had moderate to severe mental distress, and 60.8% had symptoms of post-traumatic distress disorder (PTSD) 41 .…”

Section: Discussionmentioning

confidence: 99%

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Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations

Kakaje

Alhalabi

Alyousbashi

et al. 2021

Sci Rep

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Allergic rhinitis (AR) is a common medical condition worldwide. It is an inflammation in the nasal mucosa due to allergen exposure throughout the year. Laryngopharyngeal reflux (LPR) is another medical condition that can overlap with AR. LPR can be considered an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity. Its diagnosis imposes a real challenge as it has a wide range of unspecific symptoms. Although AR and LPR are not life-threatening, they can severely affect the quality of life for years and cause substantial distress. Moreover, having AR is associated with having asthma which is also in turn associated with GORD. This is a cross-sectional study which used surveys distributed online on Social Media and targeted people across Syria. All participants who responded to the key questions were included. Reflux symptom index (RSI) was used for LPR, and score for allergic rhinitis (SFAR) was used for AR. Demographic questions and whether the participant had asthma were also included in the survey. We found that there was an association between the symptoms of LPR and AR p < 0.0001 (OR, 2.592; 95% CI 1.846–3.639), and their scores were significantly correlated (r = 0.334). Having asthma was associated with LPR symptoms p = 0.0002 (OR 3.096; 95% CI 1.665–5.759) and AR p < 0.0001 (OR 6.772; 95% CI 2.823–16.248). We concluded that there was a significant association between having LPR, AR, and asthma. We need more studies to distinguish between their common symptoms and aetiologies.

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Laryngopharyngeal reflux in war-torn Syria and its association with smoking and other risks: an online cross-sectional population study

Cited by 10 publications

References 32 publications

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

Interactions of Consanguinity and Number of Siblings with Childhood Acute Lymphoblastic Leukemia

Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations

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