Dr. Khaldoun Tabbah is a highly experienced pulmonologist, internist, and academic with over 30 years of expertise in chest and internal medicine. He has served as a Faculty Associate Professor in the United Kingdom, Syria, and the United Arab Emirates. Dr. Tabbah received his Doctorate in Medicine from the University of Southampton, UK, in 1999 and holds a Master’s degree in Internal Medicine from the University of Aleppo, Syria. He trained at Southampton General Hospital, England, gaining extensive clinical and research experience. A prolific researcher, Dr. Tabbah has published over 50 articles in indexed international journals, authored two chapters in respiratory medicine textbooks and medical encyclopedias, and delivered more than 25 presentations at national and international conferences. His primary research interests focus on asthma and allergic disorders. He is an active member of the European Respiratory Society, the Emirates Respiratory Society, and the Syrian Respiratory Society.
Summary Background Indoor air pollution from a range of household cooking fuels has been implicated in the development and exacerbation of respiratory diseases. In both rich and poor countries, the effects of cooking fuels on asthma and allergies in childhood are unclear. We investigated the association between asthma and the use of a range of cooking fuels around the world. Methods For phase three of the International Study of Asthma and Allergies in Childhood (ISAAC), written questionnaires were self-completed at school by secondary school students aged 13–14 years, 244 734 (78%) of whom were then shown a video questionnaire on wheezing symptoms. Parents of children aged 6–7 years completed the written questionnaire at home. We investigated the association between types of cooking fuels and symptoms of asthma using logistic regression. Adjustments were made for sex, region of the world, language, gross national income, maternal education, parental smoking, and six other subject-specific covariates. The ISAAC study is now closed, but researchers can continue to use the instruments for further research. Findings Data were collected between 1999 and 2004. 512 707 primary and secondary school children from 108 centres in 47 countries were included in the analysis. The use of an open fire for cooking was associated with an increased risk of symptoms of asthma and reported asthma in both children aged 6–7 years (odds ratio [OR] for wheeze in the past year, 1·78, 95% CI 1·51–2·10) and those aged 13–14 years (OR 1·20, 95% CI 1·06–1·37). In the final multivariate analyses, ORs for wheeze in the past year and the use of solely an open fire for cooking were 2·17 (95% CI 1·64–2·87) for children aged 6–7 years and 1·35 (1·11–1·64) for children aged 13–14 years. Odds ratios for wheeze in the past year and the use of open fire in combination with other fuels for cooking were 1·51 (1·25–1·81 for children aged 6–7 years and 1·35 (1·15–1·58) for those aged 13–14 years. In both age groups, we detected no evidence of an association between the use of gas as a cooking fuel and either asthma symptoms or asthma diagnosis. Interpretation The use of open fires for cooking is associated with an increased risk of symptoms of asthma and of asthma diagnosis in children. Because a large percentage of the world population uses open fires for cooking, this method of cooking might be an important modifiable risk factor if the association is proven to be causal.
The aim of these clinical standards is to aid the diagnosis and management of asthma in low resource settings in low- and middle-income countries (LMICs). CONCLUS ION: These first consensus-based clinical standards for asthma management in LMICs are intended to help clinicians provide the most effective care for people in resource-limited settings.
Folic acid intake prevents neural tube defects in the developing foetus. Folic acid allergy in pregnancy is very rare. Most physicians are unaware of this complication. Only 29 cases of folic acid allergy, mainly in non-pregnant women, have been reported in literature worldwide since 1949. In most reported cases, the involvement of folic acid was confirmed by the absence of symptoms after withdrawing folic acid. We present a case of folic acid allergy in a primigravida. The patient developed severe urticaria within hours of folic acid intake, followed by mild vaginal bleeding. Her symptoms improved within days of stopping folic acid. She delivered a healthy baby at term without anomalies or pregnancy complications. Allergy to folic acid was confirmed postnatally by oral intake of a lower dose of folic acid, where the patient again had urticaria that resolved when the medication was stopped.
Background: Nicotine use among the youth has been on the rise, especially with the introduction of E-cigarettes. This has sparked concerns regarding E-cigarettes and traditional cigarettes in terms of patterns, dependence, and perceptions within the youth population, which are issues this study aimed to investigate. Methods: A cross-sectional survey was conducted among university students at Ajman University, which is in the Middle East and North Africa (MENA) region. Using the Cigarette Dependence Scale (CDS-12) and Penn State Electronic Cigarette Dependence Index (PS-ECDI), dependence on both cigarettes and E-cigarettes was quantified. Results: Out of 1713 respondents, 18.9% were currently using nicotine products, including E-cigarettes (12.7%) and traditional cigarettes (5.1%). Nicotine use was significantly associated more with males than females with an odds ratio of 4.14. However, there was no difference between genders in the dependence scores. In addition, dual nicotine use and an earlier onset of nicotine consumption were associated with significantly higher dependence scores than single users and a late onset of smoking. Participants overall attributed cigarettes and E-cigarettes as equally harmful. Conclusions: Both cigarette and e-cigarette use were prevalent and associated with notable dependence. Although E-cigarettes are often promoted as cessation aids, their use in our sample did not appear to facilitate quitting and may instead sustain nicotine dependence. Targeted youth focused cessation programs and stricter marketing and sales regulations are essential to prevent further normalization. Longitudinal studies are needed to track evolving patterns and health impacts in the MENA region.
Background: With the increasing use of cigarettes and electronic nicotine delivery systems (ENDS) in young adults, growing concern exists regarding lung health among university students. While the adverse respiratory effects of smoking are well established in older populations, early functional changes among young adults remain less well studied. Identifying such changes in this vulnerable population is crucial due to the risk of detrimental long-term health effects and the role of implementing early preventive measures. This study aims to compare the effects of nicotine use, sex, and body mass index (BMI) on the spirometric lung function parameters, including FEV1, FVC, and FEV1/FVC ratio, of smokers (including cigarette, ENDS, shisha, and midwakh users) and non-smokers in a university population. Methods: This cross-sectional study was conducted at Ajman University, United Arab Emirates. A convenience sample of 652 smokers and non-smokers students was initially recruited voluntarily, of whom 630 participants met the spirometry acceptability criteria and were included in the final analysis. Lung function was assessed using spirometry performed according to the guidelines of the American Thoracic Society and European Respiratory Society. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio were recorded and expressed as percentages of predicted values based on Global Lung Function Initiative reference equations. Lung function parameters were compared according to smoking status, sex, and BMI. Results: A total of 630 students were included (60.5% males; the majority aged 20–22 years). The prevalence of smoking was 28.9% and was significantly higher among males than females (38.6% vs. 14.1%; OR = 3.86, p < 0.001). Smokers demonstrated a significantly lower FEV1/FVC ratio compared with non-smokers (0.84 ± 0.07 vs. 0.86 ± 0.07, p < 0.001), despite slightly higher predicted FEV1 and FVC values. Males exhibited higher predicted lung volumes than females, whereas females had higher FEV1/FVC ratios (p < 0.001). Lung function varied significantly across BMI categories (p < 0.001), with increasing BMI associated with higher predicted lung volumes but lower FEV1/FVC ratios. Stratified analysis showed that male smokers had the lowest FEV1/FVC ratios, while female nonsmokers had the highest. Conclusions: Smoking, sex, and BMI significantly influenced lung function in this cohort. Smokers demonstrated reduced FEV1/FVC ratios, indicating early airflow limitation. Males were more likely to smoke and had higher lung volumes, while females showed higher FEV1/FVC ratios. Increasing BMI was associated with higher lung volumes but lower FEV1/FVC ratios. These findings suggest that early pulmonary changes may occur in young adults, highlighting the importance of early screening, careful interpretation of spirometry, and the implementation of targeted public health interventions to reduce nicotine use, promote smoking cessation, and support lung health among university students.