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Youssef, N., M. A. Mohamed, M. A. Mohamed, S. M. Abd-ElKader, N. A. Abdullah, and E. A. Mohamed, "Health information need correlated with quality of life among cancer patients receiving chemotherapy: a cross-sectional study in Egypt", Quality of Life Research, vol. 28: SPRINGER VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS, pp. S142–S142, 2019. Abstract
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Mokdad, A. H., M. H. Forouzanfar, F. Daoud, C. El Bcheraoui, M. Moradi-Lakeh, I. Khalil, A. Afshin, M. Tuffaha, R. Charara, R. M. Barber, et al., "Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.", The Lancet. Global health, vol. 4, issue 10, pp. e704-13, 2016 Oct. Abstract

BACKGROUND: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013.

METHODS: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically.

FINDINGS: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60-80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred.

INTERPRETATION: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts.

FUNDING: Bill & Melinda Gates Foundation.

Safty, A. E., "Health Implications of Heavy Metal Overload", Occup Med Health Aff., vol. 2, issue 1, 2014.
Rashed, T. G., K. Abd El-Maksoud, and M. Galal, "Health Impacts of Limestone Quarrying in Abu-Rauwash area, Giza, Egypt (Abstract)", The International Conference: Africa: New Perspectives, Institute of African Research and Studies, Cairo University, Egypt, 25-27 May 2016.
Rahman, M. A., A. A. Shakour, and G. A. A. El-Ata, "Health Impacts due to Chronic Exposure to Heat stress in an Egyptian Glass Factory", Bulletin of the National Research Center, Egypt, vol. 27, issue 4, pp. 447 – 458, 2002.
Metwally, F., Amal El-Safty, and N. El-Taieb, "Health impact of environmental oxidants and particulate matter among manual metal arc welders.", Egyptian J. Occup. Med., vol. 24, issue 1, pp. 57-69., 2000.
Amal El-Safty, F. Metwally, and N. E. Taieb, "Health impact of environmental oxidants and particulate matter among manual metal arc welders", Egyptian J. Occup. Med. , vol. 24, issue 1, pp. 57-69., 2000.
Al-Hazmi, M., S. Ali, E. - S. Fahim, A. I. Ahmed, and N. Al-hazmi, "Health hazards of subchronic exposure to car fuel ( MTBE ) in one of Jeddah gas station and lab : A study of behavioral, biochemical and histological changes in mice. ", National Confernce for environmental protection and pollution, 2007.
Al-Hazmi, M., S. Ali, E. - S. Fahim, A. I. Ahmed, and N. Al-hazmi, "Health hazards of subchronic exposure to car fuel ( MTBE ) in one of Jeddah gas station and lab : A study of behavioral, biochemical and histological changes in mice.", National Confernce for environmental protection and pollution, 25 -28 Feb, 2007.
Abdel-Maksoud, N., and Amal El-Safty, "Health Hazards of Occupational Exposure to Anesthesia. ", Egyptian J. Occup. Med., vol. 20, issue 1, pp. 117-124., 1996.
Ahmed, Z. M., A. A. H. Bakr, A. E. K. H. Ahmed, S. S. Mona, and K. A. Howaida, "Health hazards of Nitroglycerine and Trinitrotoluene among workers in a Military Factory", Egyptian J of Occupational Medicine, vol. 21, issue 1, pp. 51-64, 1997.
Ahmed, Z. M., A. H. Aboubakr, A. E. K. H. Ahmed, S. S. Mona, and K. A. Howaida, Health hazards of Nitroglycerine and Trinitotoluene among workers in a military factory , , Cairo, Cairo, 1996.
ezz, H. A. S., Y. A. Khadrawy, and I. M. Mourad, Health Hazards of Bisphenol A. The effect of bisphenol A on vital organs of adult rat, , Germany, LAP Lambert Academic Publishing, Saarbrücken, Deutschland , 2015. the_book.pdf
ezz, H. A. S., Y. A. Khadrawy, and I. M. Mourad, Health Hazards of Bisphenol A. The effect of bisphenol A on vital organs of adult rat, , Germany, LAP Lambert Academic publishing, Saarbrucken, Deutschland, 2015.
NH, Z., H. SF, and A. L. - F. S, "Health Hazards in workers exposed to vinyl/ polyvinyl chloride in the cable industry", The Egyptian Journal of occupational Medicine, vol. 32, issue 2, pp. 327-345, 2008. final20pvc20paper1.doc
EL-BIDAWY, M. A. H. M. O. U. D. H. A. S. S. A. N., M. Zeerban, and W. M. Alharizi, "Health Hazards from High Power Electrical Lines Electromagnetic Field (EMF) Exposure in Riyadh Area Saudi Arabia", American Journal of Health Research, vol. 6, issue 4, 2018. health_hazards_from_exposure_to_emf_research.pdf
Helal, S. F., and W. S. E. Shafy, "Health hazards among workers in plastic industry", Toxicology and Industrial Health, vol. http://tih.sagepub.com/content/early/2012/05/18/0748233712442728, pp. on line, 2012. full_paper.pdf
Zaghloul AM, A. B. Frederic, S. S. Mona, and R. S. Randa, "Health hazards among workers in flour milling industry", Egyptian J of Occupational Medicine, vol. 16, issue 2, pp. 217-226, 1991.
Ahmed, E. M., E. - S. K. Amal, and S. S. Mona, "Health hazards among spray painters", Egyptian J of Occupational Medicine, vol. 20, issue 1, pp. 7-13, 1996.
Emara, A., Amal El-Safty, and M. Siha, "Health Hazards Among spray painters. ", Egyptian J. Occup. Med. , vol. 20, issue 1, pp. 7-13, 1996.
F, H. S., and L. D. A, "HEALTH HAZARDS AMONG FIRE FIGHTERS", Central European Journal, vol. 4, issue 15, pp. 3-14, 2009. fire_fighters.doc
Amal El-Safty, and N. Abdel-Maksoud, "Health Hazards Among Autopsy Workers. ", . Egyptian J. Occup. Med., vol. 17, issue 2, pp. 163-168., 1993.
D.A.El-Gindy, B.M.S.Lotfy, and N.A.El-Dib, "Health hazards affecting waste collectors at Cairo University Hospitals, with a proposed health surveillance program. ", The Egypt. J. of Internal Medicine, vol. 10, issue 4, pp. 115-125, 2000.