{
  "abstract": "Background: Physicians face substantial occupational, psychological, and cardiovascular risk factors predisposing them to chest pain, yet no large-scale study has examined this in the Middle East and North Africa (MENA). This study determined the prevalence, characteristics, and determinants of chest pain among MENA physicians. Methods: This multinational cross-sectional study enrolled 6,224 physicians from 12 MENA countries (August–December 2023). Chest pain was classified using the Rose Angina Questionnaire. Anxiety and panic disorder were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Panic Disorder Screener (PADIS). Binary and multinomial logistic regression identified independent determinants. Results: Overall, 795 (12.8%) met criteria for definitive anginal pain and 2,836 (45.6%) for possible anginal pain. In the adjusted binary model, panic disorder was the strongest predictor (AOR = 2.76, 95% CI: 2.44–3.13), followed by physical comorbidities (AOR = 1.91), sleep deprivation (AOR = 1.61), female sex (AOR = 1.49), anxiety disorder (AOR = 1.38), and obesity (AOR = 1.30). All nicotine product categories were independently associated with chest pain. Multinomial analysis revealed stronger associations of panic disorder (AOR = 3.52) and tobacco use with definitive anginal pain, while electronic nicotine delivery system (ENDS) use was significant only for possible anginal pain. Middle-income country physicians had higher odds than those from high-income countries (AOR = 1.71). Conclusion: Chest pain was highly prevalent among MENA physicians, and was strongly associated with panic disorder, anxiety, sleep deprivation, and nicotine product use. Integrated occupational health programmes addressing both psychological and cardiovascular risk are urgently needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar",
    "Faculty of Medicine, Benha University, Benha, Egypt",
    "Faculty of Pharmacy, International University for Science and Technology (IUST), Daraa, Syrian Arab Republic",
    "Faculty of Medicine, Menoufia University, Menoufia, Egypt",
    "Faculty of Medicine, Portsaid University, Portsaid, Egypt",
    "Faculty of Medicine, Alazhar University, Asyut, Egypt",
    "Faculty of Medicine, Alazhar University, Cairo, Egypt",
    "Omdurman Islamic University Faculty of Medicine, Khartoum, Sudan",
    "Alkindy College of Medicine, Baghdad University, Baghdad, Iraq",
    "Faculty of Medicine, Hashemite University, Zarqa, Jordan",
    "Department of Physiology, Faculty of Medicine, Sana’a University, Sana’a, Yemen",
    "Vice Dean of Education and Student Affairs, Faculty of Medicine, Benha University, Banha, Egypt"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Saadi M. Saleh"
    },
    {
      "affs": [
        1
      ],
      "name": "Weam Aldiban"
    },
    {
      "affs": [
        2
      ],
      "name": "Alaa Aljamala"
    },
    {
      "affs": [
        3
      ],
      "name": "Khaled Gadallah"
    },
    {
      "affs": [
        4
      ],
      "name": "Omar Habib"
    },
    {
      "affs": [
        5
      ],
      "name": "Mansour Algazar"
    },
    {
      "affs": [
        6
      ],
      "name": "Omar Abdalazeez"
    },
    {
      "affs": [
        7
      ],
      "name": "Safia Abdi"
    },
    {
      "affs": [
        8
      ],
      "name": "Noorulhuda Oudah"
    },
    {
      "affs": [
        9
      ],
      "name": "Hamza I. Alhamdan"
    },
    {
      "affs": [
        10
      ],
      "name": "Bushra M. Rageh"
    },
    {
      "affs": [
        11
      ],
      "name": "DARS Consortium"
    },
    {
      "name": "Rasha Shaker Eldesouky"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cp5e263772rph.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0355946",
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  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0355946",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3600|Healthcare professionals’ stress and burnout"
    ],
    [
      "plos",
      "/Biology and life sciences/Neuroscience/Cognitive science/Cognitive psychology/Clinical psychology"
    ],
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      "plos",
      "/Biology and life sciences/Physiology/Physiological parameters/Body weight/Obesity"
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      "/Biology and life sciences/Psychology/Cognitive psychology/Clinical psychology"
    ],
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  "openalex": "W7204784917",
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  "published": "2026-08-31",
  "publisher": "Public Library of Science",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:clinical psychology",
      "subfield": "psychiatry"
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  "title": "Prevalence, characteristics, and determinants of chest pain among physicians in the Middle East and North Africa: A multinational cross-sectional study",
  "title_text": "Prevalence, characteristics, and determinants of chest pain among physicians in the Middle East and North Africa: A multinational cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/cp5e263772rph",
  "venue": "PLOS One",
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