Overweight and Obesity in the Eastern Mediterranean Region
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RESULTS: Awakening and extubation times were significantly shorter in the BIS group (P < 0.05). In the BIS (vs. non BIS) group, there were no significant differences observed in the me to obtain an Aldrete score of 9. The sevoflurane consumption and cost in the BIS group were lower than in the non BIS group (P < 0.05).
obese patients provides statistically significant reduction in recovery times. It also has the added advantage in decreasing sevoflurane consumption.
Anaesth Intensive Care. 2008 Jan;36(1):69-73. Safety of Percutaneous Tracheostomy in Obese Critically Ill Patients: A Prospective Cohort Study. Aldawood AS, Arabi YM, Haddad S. Intensive Care Unit, King Fahad Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Abstract Obesity has been described as a relative contraindication for percutaneous tracheostomy. The objective of our study was to examine the safety and complications of percutaneous tracheostomy in obese patients. We conducted a prospective cohort study of all consecutive patients who underwent percutaneous tracheostomy at a tertiary medical-surgical intensive care unit between May 2004 and October 2005. We compared percutaneous tracheostomy in obese pa ents (body mass index > or = 30 kg/m2) to non-obese patients. We documented the occurrence of the following complications: aborting the procedure, accidental extubation, conversion to surgical tracheostomy, paratracheal placement, the development of pneumothorax, major bleeding (requiring blood product transfusion or surgical intervention) or death. We also documented hypoxia, minor bleeding (requiring pressure dressing or suturing), subcutaneous emphysema and transient hypotension. During the study period, 227 percutaneous tracheostomies were performed. There were 50 percutaneous tracheostomies in the obese group and 177 in the non-obese group. In 45 obese pa ents, percutaneous tracheostomy was performed without bronchoscopic guidance. Major complications were significantly higher in obese pa ents (12% vs. 2%, P = 0.04), while the rate of minor complications was not significantly different between the two groups. There were no instances of death or pneumothorax, subcutaneous emphysema or need for surgical intervention during or in the postoperative
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period in either group. Our study suggests that percutaneous tracheostomy can be performed safely in the majority of obese patients.
The New Egyptian Journal of Medicine, 38(1), 2008, 34-39 Planning for the Development of Evidence Based Guidelines for the Nutritional Management of Obesity in Saudi Arabia. Almajwal, AM, Williams, PG, Batterham, MJ and Alothman, AM, Abstract OBJECTIVE: To seek agreement from key stakeholders on the main issues, considerations and key questions that need to be addressed when developing evidence based guidelines for nutritional management of obesity in Saudi Arabia. METHODS: Forty six health professionals (including, dietitians, physicians, academics and government representatives) participated in an invited workshop held in Riyadh in June 2007. Participants were divided into groups to discuss five topics: priority areas to include in a critical literature review, best formats for presentation of guidelines, particular local issues to consider, information to be included in appendices, and methods to encourage the adoption and use of the guidelines. A questionnaire was also distributed to participants and they were asked to rank their level of agreement about issues related to the process of guideline development. RESULTS: Participants agreed that Saudi clinical practice guidelines are necessary for dietitians and other health professionals to guide effective nutritional management of obesity. They also agreed about the most important key questions that need to be addressed in the guidelines. In contrast, there was no general agreement about the best formats of the guidelines and this may be due to the limited use of the guidelines for daily practices. Participants also discussed other topics and their views are summarized Conclusion: The development of specific clinical practice guidelines for nutritional management of obesity in Saudi Arabia is warranted and will be valued by Saudi dietitians and other health professionals.
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Kuwait Medical Journal, 2008;41(4):301-303 Laparoscopic Adjustable Gastric Band for Morbid Obesity - Local Experience in Al-Ahsa Region of Saudi Arabia A R S Almulhim, L Kaman, A I Al-Sultan 1Department of Surgery and 2Department of Internal Medicine, College of Medicine, Al Ahasa, King Faisal University, Hofuf, Kingdom of Saudi Arabia Abstract OBJECTIVE: To present our experience of laparoscopic gastric banding (LAGB) for morbid obesity in the Eastern Province of Saudi Arabia Design: Retrospective reviews of patients undergoing surgery for morbid obesity. Setting: King Fahad Hospital, Hofuf, Saudi Arabia Subjects: One-hundred and eighty two (182) pa ents from January 2000 to December 2006 were included in the study. INTERVENTION: Laproscopic gastric banding Main Outcome Measures: Preoperative age, sex, body mass index (BMI), co-morbidities, operative variables and postoperative hospital stay and complications were recorded. The postoperative weight loss was recorded at three monthly intervals. RESULTS: The mean age was 30.3 years (range 18 - 51 years) and the mean BMI was 52.6 kg per square meter (range 41 - 61.5 kg per square meter). There were two conversions to open procedure because of dense adhesions from previous surgeries. The mean opera ve me was 2.7 hours (range 1.25 - 3.5 hours). The mean postopera ve hospital stay was 3.7 days (range 2 - 12 days). There was no mortality. Three pa ents had band removal after one year postopera vely. The mean follow up period was 11 months (range 3 - 40 months). The mean BMI decreased to 50.2, 45.4, 41.2 and 37.7 kg per square meter at 3, 6, 9 and 12 months postopera vely, with an average excess weight loss reduc on of 43.5% a er one year. CONCLUSIONS: Laproscopic gastric banding is an effective and safe procedure for the treatment of morbid obesity in Saudi patients.
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The New Egyptian Journal of Medicine, 2008;38(1):34-39. Planning For the Development of Evidence Based Guidelines for the Nutritional Management of Obesity in Saudi Arabia Ali M. Almajwal, PhD Candidate*; Peter G. Williams, Asso Prof.*; Marijka J. Batterham, PhD*; Abdulaziz M. Alothman, Asso Prof.† *From University of Wollongong, School of Health Sciences, Australia , † From King Saud University, College of Applied Medical Sciences, Saudi Arabia. Correspondence to: Ali Almajwal, University of Wollongong, School of Health Sciences, Australia, 2522. Email: aalmejwal@hotmail.com Abstract OBJECTIVE: To seek agreement from key stakeholders on the main issues, considerations and key questions that need to be addressed when developing evidence based guidelines for nutritional management of obesity in Saudi Arabia. METHODS: Forty six health professionals (including, dietitians, physicians, academics and government representatives) participated in an invited workshop held in Riyadh in June 2007. Par cipants were divided into groups to discuss five topics: priority areas to include in a critical literature review, best formats for presentation of guidelines, particular local issues to consider, information to be included in appendices, and method to encourage the adoption and use of the guidelines. A questionnaire was also distributed to participants and they were asked to rank their level of agreement about issues related to the process of guideline development.
necessary for dietitians and other health professionals to guide effective nutritional management of obesity. They also agreed about the most important key questions that need to be addressed in the guidelines. In contrast, there was no general agreement about the best formats of the guidelines and this may be due to the limited use of the guidelines for daily practices. Participants also discussed other topics and their views are summarized CONCLUSION: The development of specific clinical practice guidelines for nutritional management of obesity in Saudi Arabia is warranted and will be valued by Saudi dietitians and other health professionals.
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Saudi Med J. 2007 Dec;28(12):1875-80. The Prevalence of Abdominal Obesity and Its Associated Risk Factors in Married, Non-Pregnant Women Born and Living in High Altitude, Southwestern, Saudi Arabia. Khalid ME. Department of Physiology, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. mhkhalid999@yahoo.com Abstract OBJECTIVE: To determine the prevalence of abdominal obesity and it's associated risk factors in a married, non-pregnant, high altitude female population.
with 438 currently married non-pregnant women aged 18-60 years, born and permanent residents in and around Abha, southwestern heights, Kingdom of Saudi Arabia. A questionnaire describing the demographic, social, reproductive, physical activity, and educational status was completed. The subjects were measured by weight, height, and waist circumference (WC). Body mass index (BMI) was calculated for each woman (BMI=weight [Kg]/height [m2]). Abdominal obesity was defined as WC>88cm, and total obesity as BMI > or =30 according to the World Health Organization criteria. RESULTS: The overall prevalence of abdominal obesity was 41.1%. The prevalence was positively and significantly associated with age, total obesity, and parity (p=0.0001 for all), nega vely and significantly with educa onal level (p=0.0001), and nega vely and insignificantly with strenuous physical ac vity (p=0.9). Results of mul ple logis c analyses showed that age, total obesity, and educational level were independent risk factors for abdominal obesity.
obesity and showed that in addition to total obesity, intra-abdominal fat deposition is influenced by other lifestyle and reproductive factors. Community health education programs, which provide information on the high prevalence of abdominal obesity and its risk factor to all women, will be certainly justifiable, and prevention strategies should be implemented accordingly.
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Saudi Med J. 2007 Oct;28(10):1569-74. Prevalence and Trends in Obesity among School Boys in Central Saudi Arabia between 1988 and 2005. Al-Hazzaa HM. Exercise Physiology Laboratory, King Saud University, Riyadh, Kingdom of Saudi Arabia. halhazzaa@hotmail.com Abstract OBJECTIVE: To determine the trends in body fatness and obesity among Saudi primary schoolboys using the data from 2 cross-sectional studies conducted in 1988 and 2005.
conducted in 1988 and the second (n=702) set was conducted in 2005. Both studies used multistage random samples involving primary-school boys aged 6-14 years from Riyadh, Kingdom of Saudi Arabia. Measurements included weight (Wt), height (Ht), biacromial (BA) and bi-iliac (BI) widths, triceps (T), subscapular (S) skinfolds, S/T ratio, body mass index (BMI), body fat percentage (fat%), lean body mass (LBM), and the proportion of obese boys (fat% > or =25% of Wt). RESULTS: From 1988-2005 there were significant increases in all variables except LBM. The lowest changes were observed in body structures (Ht, BA, and BI) and the highest were in body fatness (T, S, and fat%). During this 17- year period, the mean BMI standard devia on increased from 16.5 +/- 2.1 to 18.0 +/- 4.0 kg/m2 and fat percentage increased from 13.2 +/- 4.7 to 19.7 +/- 10.0%. In addi on, S/T ra o increased by 13.5%, indica ng shi s toward central obesity over time. However, the biggest increase was seen in the propor on of obese schoolboys (from 3.4% in 1988 to 24.5% in 2005). CONCLUSION: Findings indicate rising trends in BMI, body fatness, central obesity, and prevalence of obesity among Saudi schoolboys over the last 2 decades. Increased obesity prevalence among Saudi children is a major public health concern.
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Saudi Med J. 2007 Aug;28(8):1191-7. Hormonal Levels of Leptin, Insulin, Ghrelin, and Neuropeptide Y in Lean, Overweight, and Obese Saudi Females. Daghestani MH, Ozand PT, Al-Himadi AR, Al-Odaib AN. Department of Zoology, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. Abstract OBJECTIVE: To studied the relationship that exists between leptin, ghrelin, insulin, neuropeptide Y (NPY), anthropometric, and metabolic variables in Saudi females.
Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia from November 2004 to August 2005. One hundred and twenty-two Saudi females were divided into 3 body mass index (BMI) groups: lean (N=60), overweight (N=17), and obese (N=45). Fas ng lep n, ghrelin, insulin, NPY and glucose concentrations were determined. RESULTS: Leptin levels in overweight and obese groups were significantly higher than those in lean group. Leptin levels showed a positive correlation with BMI in obese (0.81), overweight (0.78), and lean (0.48). In contrast, ghrelin concentration decreased in obese and overweight subjects compared to lean subjects. Ghrelin levels were negatively correlated with BMI in obese (-0.81), overweight (-0.58), and lean subjects (-0.62). Nega ve correlations were found between serum insulin and ghrelin concentrations in lean and obese subjects. Glucose and insulin levels were significantly higher in the obese group compared to controls. No differences were found in serum NPY between the 3 groups. CONCLUSION: Leptin levels increased remarkably with increasing BMI. A leptin resistance state seems to exist in many obese and overweight individuals. Ghrelin concentration was decreased in overweight and obese subjects. These data demonstrate a significant inverse relationship between ghrelin and leptin levels in overweight and obese subjects.
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Ann Saudi Med. 2007 Jul-Aug;27(4):241-50. Epidemiology, Clinical and Complications Profile of Diabetes in Saudi Arabia: A Review. Elhadd TA, Al-Amoudi AA, Alzahrani AS. Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah. tarikelhadd58@gmail.com Abstract Diabetes mellitus is emerging as a major public health problem in Saudi Arabia in parallel with the worldwide diabetes pandemic, which is having a particular impact upon the Middle East and the third world. This pandemic has accompanied the adoption of a modern lifestyle and the abandonment of a traditional lifestyle, with a resultant increase in rates of obesity and other chronic non-communicable diseases. The indigenous Saudi popula on seems to have a special gene c predisposi on to develop type 2 diabetes, which is further amplified by a rise in obesity rates, a high rate of consanguinity and the presence of other variables of the insulin resistance syndrome. We highlight the epidemiology, clinical and complications profiles of diabetes in Saudi people. Diabetes is well studied in Saudi Arabia; however, there seems to be little research in the area of education and health care delivery. This is of paramount importance to offset the perceived impact on health care delivery services, to lessen chronic diabetes complications, and to reduce the expected morbidity and mortality from diabetes.
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Cardiovasc Diabetol. 2007 Jul 7;6:18. Serum Leptin And Its Relation to Anthropometric Measures of Obesity in Pre-Diabetic Saudis. Al-Daghri NM, Al-Attas OS, Al-Rubeaan K, Mohieldin M, Al-Katari M, Jones AF, Kumar S. Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia. aldaghri2000@hotmail.com
individuals with IGT. This study aims to determine and correlate leptin levels to anthropometric measures of obesity in pre-diabetic, (IFG and IGT), type 2 diabe c and normoglycaemic Saudis. METHODS: 308 adult Saudis (healthy controls n = 80; pre-diabetes n = 86; Type 2 diabetes n = 142) par cipated. Anthropometric parameters were measured and fasting blood samples taken. Serum insulin was analysed, using a solid phase enzyme amplified sensitivity immunoassay and also leptin concentrations, using radio-immunoassay. The remaining blood parameters were determined using standard laboratory procedures. RESULTS: Leptin levels of diabetic and pre-diabetic men were higher than in normoglycaemic men (12.4 [3.2-72] vs 3.9 [0.8-20.0] ng/mL, (median [interquar le range], p = 0.0001). In females, lep n levels were significantly higher in pre-diabetic subjects (14.09 [2.8-44.4] ng/mL) than in normoglycaemic subjects (10.2 [0.25-34.8] ng/mL) (p = 0.046). A er adjustment for BMI and gender, hip circumference was associated with log lep n (p = 0.006 with R2 = 0.086) among all subjects.
circumference in particular, in the non-diabetic state among Saudi subjects. The higher leptin level among diabetics and pre-diabetics is not related to differences in anthropometric measures of obesity. 551
Saudi Med J. 2007 Jul;28(7):1096-101. Growth Pattern among Primary School Entrants in King Abdul-Aziz Housing City for National Guard in Riyadh, Saudi Arabia. Al-Rowaily M, Al-Mugbel M, Al-Shammari S, Fayed A. Department of Family and Community Medicine, King Fahad Hospital for National Guard, Riyadh, Kingdom of Saudi Arabia. Abstract OBJECTIVE: To provide information on nutritional status of primary school entrants at King Abdul-Aziz Housing City for National Guard in Riyadh, Saudi Arabia and compare it with national and international studies of anthropometric data on weight and height. METHODS: A cross-sectional study carried out at the School Health Clinic in King Abdul-Aziz Housing City for National Guard in Riyadh, Saudi Arabia. The study popula on comprised 6207 children aged 4-8 years from both sexes attending the obligatory pre-school health examina on for years 2003- 2005. Weight, height, and demographic data were collected according to international standards and the body mass index (BMI) calculated. The data were computer analyzed using Statistical Package for Social Sciences and Anthro 2005 and compared to interna onal references. RESULTS: Obesity, defined as BMI<95th cen le in our popula on was found to be 4%, which is less than the na onal and interna onal references. This also applies to underweight, defined as Weight-for-Height Z score less than -2 SD, which was found to be 5.8%. While stun ng, defined as height Z score less than -2 SD was higher than interna onal references (5.9%). Download 5.37 Mb. Do'stlaringiz bilan baham: 
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