{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:14:41Z","timestamp":1787800481339,"version":"build-2784847793"},"reference-count":33,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,5]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To demonstrate the burden of laryngopharyngeal reflux (LPR) in Syria and its associated variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a cross-sectional study that used online questionnaires that included demographics, smoking, war-related questions and reflux symptom index (RSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This research was conducted online across Syria and included the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants who lived in Syria, agreed to participate, and responded to all the RSI questions were included. This research comprised 734 participants, with 94.6% response rate, 75.5% being females, and a mean age of 24 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 31.9% of subjects had symptoms suggestive of LPR. Participants who were 30 years and younger had fewer symptoms suggestive of LPR compared with the older group p=0.012 (OR 0.534; 95%\u2009CI 0.325 to 0.877). While having an epigastric burning sensation, chest pain and indigestion were the most common symptoms, having a sore throat was the least common. Being distressed from war noises was associated with more symptoms p=0.009 (OR 1.562; 95%\u2009CI 1.117 to 2.183). However, losing someone or changing place of living due to war were not significantly associated with these symptoms p&gt;0.05. RSI scores were associated with cigarette and\/or shisha smoking p&lt;0.05. Finally, asthma, allergic disorders and having a job were associated with having LPR symptoms p&lt;0.05. No significant findings were observed in consanguinity, marital status, educational level and socioeconomic status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>War, smoking, asthma, allergies, respiratory conditions and having a job were associated with LPR symptoms. However, they may be associated with these symptoms independently from LPR; for instance, similar symptoms can be caused by the mental disorders from war, the unique environment and irritant substances of the laryngeal mucosa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041183","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T15:37:09Z","timestamp":1606405029000},"page":"e041183","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Laryngopharyngeal reflux in war-torn Syria and its association with smoking and other risks: an online cross-sectional population study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3949-6109","authenticated-orcid":false,"given":"Ameer","family":"Kakaje","sequence":"first","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Marwan","family":"Alhalabi","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayham","family":"Alyousbashi","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Hamid","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"2025121410410573000_10.11.e041183.1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1991.101.s53.1"},{"key":"2025121410410573000_10.11.e041183.2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200409000-00004"},{"key":"2025121410410573000_10.11.e041183.3","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.109935"},{"key":"2025121410410573000_10.11.e041183.4","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200212000-00013"},{"key":"2025121410410573000_10.11.e041183.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000165464.75164.E5"},{"key":"2025121410410573000_10.11.e041183.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.12.1534"},{"key":"2025121410410573000_10.11.e041183.7","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200108000-00001"},{"key":"2025121410410573000_10.11.e041183.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00097-8"},{"key":"2025121410410573000_10.11.e041183.9","doi-asserted-by":"crossref","unstructured":"Kakaje A , Alhalabi MM , Alyousbashi A , et al . 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