Syrian Population Research Articles

Prevalence of Keratoconus in a Population-Based Study in Syria.

Aim To determine the prevalence and associations of keratoconus (KC) in a university student population in Syria. Methods A prospective multicentre cross-sectional cohort study was conducted at two universities in Syria. Student volunteers were recruited from Tishreen University (Latakia governorate) and Damascus University (Damascus governorate). All participants underwent a comprehensive ocular examination. Placido/Scheimpflug-based corneal imaging using the Sirius (CSO, Florence. Italy), and a questionnaire to evaluate the baseline characteristics and medical history, as well as to highlight possible risk factors of KC. Univariate and bivariate analyses were performed. Results The estimated prevalence of KC among all subjects was 1.43% (n = 12). A strong association between eye rubbing and keratoconus was found (OR 9.33, 95% CI 2.94–29.63, P < 0.001). Damascus University participants had a higher prevalence of KC than Tishreen University. However, the difference was not statistically significant. Conclusion The prevalence of keratoconus in this Syrian student population was 1.43%. The results of this study demonstrate a high prevalence of keratoconus in the study population. Early detection of keratoconus through screening may yield benefits in preventing devastating sequelae of KC in populations with a high prevalence.

Association between A986S polymorphism of CaSR gene and concentration of 25-OH vitamin D in healthy syrians

The calcium Sensing Receptor (CaSR) and vitamin D are considered as essential factors for regulation and sensing the minor changes in calcium concentrations in the extracellular matrix of cells. It is still unclear whether single nucleotide polymorphisms (SNPs) of CaSR gene have effects on vitamin D level. The aim of this study is to evaluate the relationship between CaSR gene polymorphism A986S and 25-OH vitamin D levels in healthy Syrian population. MethodsA total of 197 healthy Syrians individuals (Aged 18 to 50 years. Female: 131 and male: 66) were recruited in this study. Based on vitamin D serum concentration in serum, participants were divided into four groups: sufficiency (G1) (Vit.D > 30 ng/ml), insufficiency (G2) (Vit.D: 20–30 ng/ml), deficiency (G3) (Vit.D: 10–20 ng/ml), and severe deficiency (G4) (Vit.D < 10 ng/ml). All the subjects were genotyped at the CaSR A986S with PCR followed by SacI restriction enzyme digestion and agarose gel electrophoresis. ResultsThe frequency of genotypes A986S for the whole study participants was 59.9% (AA), and 35.5% (AS) and 4.6% (SS). Allele frequencies for A and S were 77.7% and 22.3% respectively. Frequencies of AA, AS and SS genotypes were 94.1%, 5.9% and 0% in sufficient vitamin D group, 71.1%, 26.1% and 2.2% in vitamin D insufficiency group, 60.4%, 33.3% and 6.3% in vitamin D deficiency group, and 34.8%, 58% and 7.2% in severe deficiency of vitamin D respectively. The differences between G1 group and rest groups G2, G3, G4 were statistically significant and P value were (0.038, 0.002, <0.001), respectively. In summary, there was a strong correlation between allele S and decreased vitamin D levels. Additionally, the study reported an association between normal vitamin D levels and AA genotype of the CaSR gene in healthy Syrians.

Association of matrix metalloproteinase-8 gene promoter polymorphisms with type II diabetes mellitus in Syrian population

ObjectivesMatrix metalloproteinase (MMP)-8 is an enzyme that cleaves extracellular matrix (ECM). It is involved in many diseases' pathology including diabetes mellitus type II (DM). In MMP-8 gene promoter region, there are many polymorphisms with an important role in gene transcription modifying and protein production. -381A/G and -799 C/T SNPs are the most effective polymorphisms, and our study is the first work aimed to evaluate the association between these polymorphisms and DM susceptibility in Syrian population. Designstudy sample included 140 subjects allocated into two groups: H= healthy control, DM= diabetes mellitus. MMP-8 SNPs were determined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) technique. ResultsThe frequencies of genotypes were significantly different between study groups (adjusted OR =3.621, 95% CI: 1.391-9.428, P = 0.008 for -381GG genotype), and (OR =4.941, 95% CI: 1.640-14.890, P = 0.005 for -799TT genotype). Subjects with minor alleles seem to be more likely to develop DM more than those with the major alleles (OR=2.842, P = 0.01 for G) and (OR =3.995, P = 0.001 for T). ConclusionThis study data has illustrated that there could be a remarkable association between MMP-8 gene promoter polymorphisms -381A/G and -799C/T and diabetic susceptibility in Syrian population.

Syrian national growth references for children and adolescents aged 2–20 years

BackgroundDuring the past three decades, growth charts have become one of the principal tools for monitoring anthropometric development in individuals and populations as well. Growth references by the CDC and other countries have been widely used in our hospitals and healthcare units for clinical assessment of children’s development. The apparent overestimation and underestimation of many children's anthropometrics indicated the need to construct our own references. The objective of this study is to establish the national growth references for the Syrian population 2–20-year-old.MethodsA multicenter cross-sectional sample of 13,548 subjects, aged 2–20 years, were recruited from various kindergartens, schools, and universities across the Syrian Arab Republic between February and May-2019. Response variables (stature, weight, and BMI) were fitted against age using P-splines and three empirical distributions: Box-Cox T, Box-Cox Power Exponential, and Box-Cox Cole and Green. Residuals diagnostic Q-tests and worm plots were used to check the validity of fitted models.ResultsBox-Cox T provided the best fit for stature-for-age, whereas Box-Cox Power Exponential provided the best fit for weight-for-age and BMI-for-age. Residuals diagnostics revealed adequate models fitting. BMI cutoffs revealed an increased prevalence of obesity (4.5% and 3.66%) and overweight (20.1% and 19.54%), for boys and girls respectively, in our population.ConclusionsGrowth charts are available for use now in our hospitals and healthcare units. For 0–2-year-old children, we recommend using the World Health Organization’s standards.

Child Labor Among Syrian Refugees in Turkey

Nearly 4 million Syrian refugees, including more than 1.8 million Syrian children, fled to Turkey during the Syrian war, where they face many challenges to rebuild their lives. They are confronted with restrictions on their residence status and access to the labor market, limiting their formal employment opportunities. Poverty and labor exploitation are widespread consequences, and to make ends meet, children are driven into the workforce. In Turkey, child labor among Turkish nationals is also widespread as follows from the Turkish national child labor survey from 2019, creating a fertile ground for Syrian children to take up work. Although child labor among the Syrian refugee population is gaining increasing attention among scholars and humanitarian actors, knowledge about its extent or characteristics remains limited. Drawing on a survey conducted in late 2020, this paper contributes to a deeper and more numerically based understanding of the current situation of Syrian minor workers in Turkey. The quantitative results of our research are compared with the Turkish national child labor survey, highlighting the differences and commonalities between Syrian and Turkish children working in the country and looking into the impact of the lack of permanent residency on the prevalence of child labor. Our findings suggest that Syrian children enter the labor force at a younger age and have less access to education while working very long hours and earning low wages. The study thus demonstrates the specific vulnerabilities of Syrian children to labor exploitation.

Association between ABO Blood Group and Epistaxis among Syrian Population

Background: Epistaxis is one of the most common otorhinolaryngologic emergencies in ear, nose,and throat clinics. Blood grouping is routinely done in patients with epistaxis.Objectives: To determine the association between ABO blood type and epistaxis.Methods: This retrospective study involved 260 patients with idiopathic epistaxis. Patients withrisk factors for bleeding, including anticoagulant use, thrombocytopenia, hypertension, liverdiseases, elevated bleeding time, low coagulation factor levels, or any benign/malignant tumor,were excluded from the study. Thus, only patients with idiopathic epistaxis were included in thisstudy.Results: The distributions of blood groups in patients with idiopathic epistaxis were(AB &lt; B&lt;A&lt;O), with highly trending with male gender. Also, more frequent in age category 6 – 12y, 13 – 20 y, 1 – 5 y, 46 – 70 y, 21 – 45 y respectively, with no pervious history of nasal trauma(71.92%). Most of patients were no correlation with nasal disorders or deformity (73.84 %), alsovast majority of them need no intervention for epistaxis i.e., conservative treatment (81.15 %).Conclusions: Our study indicates that in the Syrian population, the O blood type is over-representedin patients with idiopathic epistaxis versus the general population. We conclude that blood type Ois a risk factor for idiopathic epistaxis in the Syrian population.

Contribution of International Non-Governmental Organizations to Peaceful Conflict Resolution Processes: The Case of the Syrian Conflict

Due to the increase in the number of conflicts, which lead to the growth of tension and destabilization of the system of international relations, the search for new mechanisms for their settlement and new participants who are able to introduce a positive agenda through interaction with all parties is an urgent research task. This paper focuses on international non-governmental organizations (INGOs), acting as such new actors and taking part in the settlement of the conflict in Syria. The purpose of the article is to analyze their contribution to the Syrian peace process, to consider their possibilities and limitations. The methodology is based on discourse analysis and case studies. The case of Syria was chosen because of the ongoing nature of the civil war there, as well as the fact that INGOs have proposed a number of new initiatives to resolve the conflict, which makes this study novel. The study identified the main organizations that propose a peaceful settlement of the conflict, and also identified the main trends in the participation of INGOs in the crisis settlement in Syria. Thus, participating in the peace process, they also implement peacebuilding projects, actively cooperate with local INGOs, and switch to remote work formats due to security problems. However, the analysis of their proposals for the peace process also revealed the main problems of the activities of INGOs within the framework of track II diplomacy, which consist in their neglect of the principle of impartiality. The ability of INGOs to promote their initiatives is also influenced by the dynamics of traditional diplomacy. The key takeaway is that, despite the complexity of the Syrian peace process and the dominant role of traditional diplomacy, INGOs have a significant positive impact on the peace process as they promote grassroots cohesion among the Syrian population and encourage them to form civil associations similar to INGOs, which are also gradually beginning to look for ways of national reconciliation.

ACCESS TO HEALTHCARE SERVICES AMONG SYRIAN REFUGEES IN TURKEY

The Syrian population influx has dislocated a significant number of people (6.7 million of people outside the Syrian borders, 6.5 million of people among the different provinces of Syria). The biggest group among this moving population between borders has integrated into the Turkish society, and economy. From the macro and micro perspectives, the health system integration is significantly graded by the Syrian population. We will focus on the early age group, among the refugees, as their health vulnerabilities, and health improvements will create much larger effects throughout their lifetime. What we aim in this paper is to bring forward an objective micro-level outcome that will allow us to measure two things that was crucial in the life cycle of the refugee population: the war effect which will create a push factor for them to start moving, and an integration effect which will measure the time-continuous, and time-discrete increase in their health outcomes, as a result of relatively cost-free integration into a more developed health system. The Demographic Health Survey (DHS) 2018 data that we utilize gives us an empirical advantage for identification for two reasons; it differentiates the health outcome of children, in multi-child families depending on where they were born, which we will call an intra-Syrian effect, and it allows us to compare the situation of the Syrian children vis-a-vis the average child health outcomes in the society they are integrating into (what we call the inter-Syrian effect). The results suggest that Syrians remain underneath the Turkish average, for many early child development, and vital health access, however, after integration significant positive developments occur, in terms of compensating for the negative war effect, and in terms of the second effect (integration/adaptation effect) that they have started to converge to the Turkish average, as they have spent more years in Turkey.

Fear among Syrians: A Proposed Cutoff Scoreforthe Arabic Fear of COVID-19 Scale.

COVID-19 pandemic has led to psychological health issues one of which is fear. This study validates the Arabic version of the fear of COVID-19 scale and suggests a new cutoff score to measure fear of COVID-19 among the Syrian Population. A total of 3989 participants filled an online survey consisting of socio-demographic information, the fear of COVID-19 scale, the patient health questionnaire 9-item, and the generalized anxiety disorder 7-item. Receiver operating characteristic analysis was used to define cutoff scores for the fear of COVID-19 scale in relation to generalized anxiety disorder 7-item and the patient health questionnaire 9-item. The Cronbach α value of the Arabic fear of COVID-19 scale was 0.896, revealing good stability and internal consistency. The inter-item correlations were between [0.420-0.868] and the corrected item-total correlations were between [0.614-0.768]. A cutoff point of 17.5 was deduced from the analysis. According to the deduced cutoff point, 2111(52.9%) were categorized as extreme fear cases. This cutoff score deduced from this study can be used for screening purposes to distinguish community members that may be prone to developing extreme fear of COVID-19. Therefore, early preventive and supportive measures can then be delivered.

Metabolic Syndrome in Overt and Subclinical Hypothyroidism Syrian Patients

Thyroid hormones have important functions in many metabolic pathways, including glucose and lipid metabolism, and may cause metabolic syndrome. Both hypothyroidism and metabolic syndrome are common in the Syrian population. This research was carried out to evaluate the incidence of the metabolic syndrome in two types of hypothyroidism and the effect of TSH levels on its occurrence. A retrospective cross-sectional study was performed of 91 overt hypothyroidism patients, 31 subclinical hypothyroidism patients without clinical symptoms, and 53 controls without thyroid disorders. We used the criteria for metabolic syndrome as per International Diabetes Federation (IDF) which are defined as central obesity depending on race- and gender-specific WC cutoffs(Waist circumference (WC)≥94 cm for male, WC≥80 cm for female) in addition to any two of the following four parameters: (Triglycerides level: ≥150 mg/dl (1.7 mmol/l) or history of treatment for TG abnormality, HDL cholesterol level: &lt;40 mg/dl (1.03 mmol/l) in males and &lt;50 mg/dl (1.29 mmol/l) in females or history of treatment for HDL cholesterol abnormality, high blood pressure: systolic BP ≥130 mm Hg or diastolic BP≥85mm Hg or on treatment for previously diagnosed hypertension and high FPG: ≥100 mg/dl or previously diagnosed type 2 Diabetes mellitus. In conclusion, our study showed a significant correlation between overt hypothyroidism and metabolic syndrome. It also revealed that a TSH level over 2.5 uIU‎/ml significantly increases the risk of metabolic syndrome.

Food Behavior in Emergency Time: Wild Plant Use for Human Nutrition during the Conflict in Syria

Wild food plants (WFPs) have been an important source of human nutrition since ancient times, and it particularly revives when conventional food is not available due to emergency situations, such as natural disasters and conflicts. The war in Syria has entered 10 years since it started in 2011, and it has caused the largest war-related crises since World War II. Nearly 60% of the Syrian population (12.4 million people) are food-insecure. WFPs are already culturally important in the region, and may be supplementing local diets during this conflict. Our study aimed to uncover the conflict’s effect on the use of WFPs and to know what species are consumed by local people during the current crisis. The fieldwork was carried out between March 2020 and March 2021 in the Tartus governorate located in the coastal region of Syria. Semi-structured interviews were conducted with 50 participants (26 women and 24 men) distributed in 26 villages along the study area. We recorded the vernacular names, uses, plant parts used, modes of preparation and consumption, change in WFP use before and during the conflict, and informants’ perceptions towards WFPs. We documented 75 wild food plant species used for food and drink. Almost two-thirds (64%) of informants reported an increase in their reliance on wild plants as a food source during the conflict. The species of Origanum syriacum, Rhus coriaria, Eryngium creticum, and Cichorium intybus were among the most quoted species by informants. Sleeq (steamed leafy vegetables), Zaatar (breakfast/dinner food), and Louf (soup) were the most popular wild plant-based dishes.

The hidden danger in Syria: Silent Celiac Disease

Celiac disease (CD) is a disorder caused by an aberrant autoimmune response to gluten ingestion in genetically susceptible individuals. Its prevalence nears 1%, and it is not considered typical in the Middle East because of the lack of reports in the Arabic countries. Therefore, this study aimed to define the prevalence of celiac disease in the Syrian community. Healthy young adults and volunteers ranging between 5–65-year-old were tested from December 2018 till May 2019. Samples from the participant's sera were tested for anti-tissue transglutaminase antibody (tTG) IgA/IgG by ELISA using the human recombinant transglutaminase antigen. One hundred participants with a mean ± SD of 22 ± 14 years-old were recruited in the study. Only one participant was suspected of having celiac disease. The mean ± SD of anti-tTG IgA/IgG values were 9.81 ± 9.61 for IgA and 6.64 ± 6.60 for IgG. The study shows no significant difference in IgA or IgG titers between males and females at P = 0.7, P = 0.8, respectively. The estimation of seroprevalence of CD antibodies in a healthy Syrian population is close to 1%. We suggest that the underdiagnosed CD might pose a high risk in Syria, contrary to previous thoughts.

Evaluation of Corneal Higher- Order Aberrations in Adults with Different Refractive Status

Purpose: The aim of this study is to evaluate the root mean square error (RMS) of corneal higher- order aberrations in Syrian adult population in different refractive status (emmetropia, myopia, hyperopia and simple myopic astigmatism). Methods: This cross- sectional study was conducted at Tishreen University Hospital in Latakia, Syrian Arab Republic. A total of 420 patients (840 eyes), ages 18- 40 years, participated in the study. Refraction was measured with an autorefractor keratometer and expressed as a spherical equivalent. Total corneal higher- order aberrations (Coma, Spherical Aberration, Trefoil) were measured using Sirius Corneal Topography at a pupil diameter of 5 mm. Results: RMS of Coma and Spherical aberrations peaked in the hyperopia group (0.18 ± 0.08, 0.11 ± 0.02) respectively. Whereas, Trefoil was higher in the severe myopia and simple myopic astigmatism groups (0.25 ± 0.05, 0.25 ± 0.08) respectively. Conclusions: Among a Syrian population, some types of refractive status were associated with certain types of higher- order aberrations, with a significant increase in trefoil in severe myopia and simple myopic astigmatism.

The situation of Syrian Christians in the context of the Arab Spring events

The article is based on the information published in foreign and Russian sources and media, as well as on the basis of the authors own research and interviews carried out in Syria. The aim of the work is to study the situation of Syrian Christians after the events of the Arab Spring-2011. This is the scientific novelty of the topic. The article is devoted to the problems that not only touched, but most dramatically affected the life of Christians in Syria, who traditionally presented at least 12% of its population (and much more in the past). They are representatives of the most indigenous religion in the Syrian Arab Republic (SAR). The work also traces the role of Christians in the history and socio-political life of Syria, analyzes their current situation, evaluates the events of recent years and draws appropriate conclusions. In particular, the author believes that the Arab Spring led not only to huge human and economic losses, but also to serious ethno-confessional structural changes in the society of the SAR. With the possible disappearance of this native part of the Syrian population, who lived here and represented almost all the inhabitants of that region before the Islam, the republic may lose not only 12 percent of the most educated and active part of its population, but also its tourist attractiveness in the eyes of the whole world. Although Syria has always been considered the cradle of Christianity it could lose its reputation as one of the most tolerant countries of the Arab world.

Pathogen diversity and mating types of Didymella rabiei isolates collected from Morocco

Ascochyta blight (Didymella rabiei) is an economically important disease of chickpea in Morocco and other parts of the world. Knowledge about pathogen diversity and their aggressiveness in the Moroccan D. rabiei population can help breeders to develop appropriate breeding strategies for the management of Ascochyta blight. The genetic diversity of 41 D. rabiei isolates collected from four major chickpea growing regions of Morocco and 40 isolates from Syria was estimated using nine polymorphic microsatellite markers. Multiplex MAT-specific PCR with three primers was used for mating types frequency analysis in the Moroccan populations. The aggressiveness of D. rabiei isolates was assessed using four chickpea differential genotypes and seven Moroccan Kabuli chickpea cultivars. The Moroccan D. rabiei population showed high genetic diversity (Ht=0.60) similar to many populations worldwide. The diversity was distributed within regions with no geographic preferences inside Morocco but with differentiation from the Syrian population. The high genetic diversity may be due to high gene flow among regions and/or to the presence of both mating types (MAT 1–1 and MAT 1–2), that can enhance the risk of sexual reproduction of D. rabiei. This genetic diversity could be responsible for the variation of Moroccan isolates in their aggressiveness on chickpea genotypes. Three pathotypes were identified, where the highly aggressive pathotype caused high disease severity on most of the released chickpea cultivars. This is the first report of pathogen diversity, mating types, and aggressiveness of D. rabiei population in Morocco. The information will be useful to breed chickpea cultivars resistant to pathotypes with high levels of aggressiveness to minimize the resistance breakdown of popular chickpea varieties.

Hambatan PBB dalam Merespon Mass Atrocity di Suriah pada Tahun 2011-2013

The Syrian conflict is one of the deadliest conflicts that occurred as a result of the Arab Spring. A large number of casualties in this conflict shows how sovereign state and international community had failed to fulfill their responsibility to protect civilians from mass atrocities. The purpose of this article is to examine what obstacles the United Nations had faced in its effort to protect the Syrian population. The framework that used to analyze this issue is the concept of Global Governance and the Responsibility to Protect. Using descriptive qualitative research methods, data will be collected from books, journal articles, official reports and media publications to explain four obstacles United Nations had faced. The first obstacle related to growing multipolarity that causes difficulty in reaching a consensus during the negotiations. The second obstacle related to UN Security Council permanent member dysfunctional behavior which often causes a deadlock in decision making. The third obstacle is the complexity of the conflict that occurred. The last one is the differences opinion among related organizations that relieves the international pressure to immediately end the mass atrocities.

İnformal İletişim Çevresinin Sosyal Uyum Üzerindeki Etkisinin İncelenmesi

The Syrian Civil War forced the citizen population to flee to neighboring countries. Turkey host one of the most densely populated Syrian asylum seekers since 2011. Therefore, social adaption, social cohesion and social integration became the most discussed topics of social studies. Most studies conducted to understand the advantages and disadvantages between two societies in social adaptation. Language is the dominant barrier to social and cultural integration. But some of the newest studies on understanding Syrian population issues shown that communication is the second challenge for the Syrian asylum seekers living in Turkey. Authorities, civic initiatives planned strategic communication facilities to access the Syrian asylum - seekers' adaptation process. So many of these implied by the formal communication sources or channels. This paper aims to direct researchers consider to the importance of informal communication for understanding a close society's communication tendencies and offers to integrate informal communication layer for providing more success.&#x0D; &#x0D; In this perspective, the paper refer the informal communication preferences of Syrian asylum-seekers in Turkey and observe the role of these preferences. So, a qualitative study applied with asylum-seekers in Turkey. As a result, the findings show that key opinion leaders, multi-lingual neighbors and social media are among the effective informal communication channels. This paper aims to start a discussion about the gap of informal communication and it may be useful for policy makers to think about this aspect of communication.

New Media and Revolution: Resistance and Dissent in Pre-Uprising Syria

New Media and Revolution: Resistance and Dissent in Pre-Uprising Syria

Association of Tumor Necrosis Factor-α Gene Promoter Polymorphisms with Periodontitisin Type II Diabetic Syrian Population

Association of Tumor Necrosis Factor-α Gene Promoter Polymorphisms with Periodontitisin Type II Diabetic Syrian Population

COVID-19 vaccination acceptance among Syrian population: a nationwide cross-sectional study

BackgroundSevere Acute Respiratory Syndrome Coronavirus 2 continues to spread globally and in the absence of an effective treatment, the vaccine remains the best hope for controlling this disease. In this study, we seek to find out the extent to which people in Syria accept the Corona vaccine and what are the factors that affect their decision.MethodsThis cross-sectional study was conducted in Syria during the period from January 3 to March 17, 2021. A structured self-administered questionnaire was distributed in two phases: The first phase included distributing the questionnaire as a Google Form on social media platforms. In the second phase, a paper version of the questionnaire was handed to patients, their companions, and workers in public hospitals. SPSS v.25 and R v.4.1.1 were used to analyze the data. Pearson Chi-square test and Logistic Regression were used to study the associations between categorical groups.ResultsOf 7531 respondents, 3505 (46.5%) were males and 4026 (53.5%) were females. 3124 (41.5%) were 18–24 years old. Healthcare workers were participants’ main sources of information (50.9%), followed by Social Media users (46.3%). 2790 (37%) of the participant are willing to be vaccinated, and 2334 (31%) were uncertain about it. Fear of possible side effects was the main reason for the reluctance to take the vaccine 1615 (62.4%), followed by mistrust of the vaccine formula 1522 (58.8%). 2218 (29.5%) participants think COVID-19 poses a major risk to them personally. Vaccination intention was significantly associated with gender, residence, financial status, educational level, and geographic origin.ConclusionThis study showed very negatively important results. The study participants Vaccination acceptance rate is almost the lowest when compared to its peers. A Lot of efforts should be made to correct misinformation about the vaccine and answer all questions about it, especially with a health system that has been ravaged by war for 10 years.