‫بسم هللا الرحمن الرحيم‬

University of Science and Technology

Department of Community Medicine

Knowledge of Female Students of

Omdurman Islamic University about Obesity
and Related Health Problems
January -2018

Prepared by:
Somaia Hafiz Ahmed (Batch 18)

Supervisor:
Nahla Elsayed Abbas

This thesis is for the fulfillment of MBBS degree of Faculty of

Medicine in University of Science and Technology

1
 Dedication

To my mother and father, it’s impossible to thank you adequately for everything you’ve done,
for loving me unconditionally. And also dedicate this to my beloved brother, my sweetheart’s
sisters and my supporting friends, to my great man.

2
 Acknowledgment

I am very thankful to community medicine department members and teacher who taught us
from their generous knowledge and my deepest thanks and respect to Dr. Nahla El-sayed
Abbas the supervisor of research for her kind heart who guided me to finish this research.

3
 Abbreviation

BMI: Body Mass Index

PCOS: Polycystic ovary syndrome

LAGB: Laparoscopic adjustable gastric banding

WHO: World health organization

4
 ABSTRACT

Obesity is a medical condition, in which excess body fat has accumulated to the extent
that it may have a negative effect on health, it can be diagnosed by several measures;
include body mass index (BMI), body- fat percentage and waist circumference. Obesity
can leads to serious health problems such as heart diseases, diabetes mellitus and high
blood pressure. And this is a descriptive cross sectional school based study done on
female students of Omdurman University by 100 pretested questionnaire, 100 student
were chosen randomly and the sample analyzed manually and by Microsoft Excel with
aim to determine knowledge of the female students about obesity and related health
problems, this study concluded that the knowledge among female student of Omdurman
university about obesity was 84%, also the result concluded that 59% of those
participants think that obesity prevent them from living their life normally. Most
participants had taken preventive measures towards obesity, although many think that
it’s not possible to get rid of obesity. And according to this study the following is
recommended that there should be exercise programs and diet so that it could be
preventive and curative methods of obesity.

5
 ‫الخالصة‬
‫البدانة هي حالة طبية ‪ ،‬تتراكم فيها الدهون الزائدة بالجسم الي درجة تتسبب معها في وقوع أثار سلبية علي الصحة‪ ،‬يمكن‬
‫تشخيصها من خالل عدة تدابير ؛ تتضمن مؤشر كتلة الجسم ‪ ،‬نسبة الدهون في الجسم ومحيط الخصر‪ .‬يمكن أن تؤدي البدانة‬
‫الي مشاكل صحية خطيرة مثل أمراض القلب ‪ ،‬السكري وارتفاع ضغط الدم‪ .‬وقد طبقت هذه الدراسة علي طالبات جامعة أم‬
‫درمان االسالمية في العام ‪ 2018‬لشهر مارس بغرض تحديد نسبة معرفة طالبات جامعة أم درمان االسالمية بالبدانة‬
‫ومخاطرها الصحية من خالل ‪ 100‬استبيان ‪ ،‬وقد تم اختيار ‪ 100‬طالبة عشوائيا وتم تحليل العينة يدويا وأيضا بواسطة‬
‫مايكروسوفت اكسل ‪ ،‬ولخصت نتائج هذه الدراسة الي أن المعرفة بين الطالبات المعنيات حول البدانة كان بنسبة ‪، %84‬‬
‫كما لخصت النتيجة الي أن ‪ %59‬من المشاركين يعتقدون أنه من غير الممكن التخلص من البدانة ‪ .‬واستنادا علي نتائج هذه‬
‫الدراسة تم التوصية علي أنه يجب اتباع حمية غذائية وممارسة التمارين الرياضية بغرض الوقاية وعالج البدانة ‪.‬‬

‫‪6‬‬
 Table

Number Content Page

1 Dedication I
2 Acknowledgment II
3 Abbreviations III
4 Abstract V
List of content VI
Chapter One : Introduction
1 Introduction 1
2 Justification 2
3 Objectives 3
6 General objectives
7 Specific objectives
Chapter Two: literature Review 4
1 Definition 5
2 Etiology 6
Chapter Three: methodology 10
Chapter Four: Results
1 Figure 1 12
2 Figure 2 13
3 Figure 3 14
4 Figure 4 15
5 Figure 5 16
6 Figure 6 17
7 Figure 7 18
8 Figure 8 19
9 Figure 9 20
10 Figure 10 21
11 Figure 11 22
12 Figure 12 23
Figure 13 24
Figure 14 25
13 Figure 15 26
14 Chapter Five: Discussion 27
7
Chapter Six: conclusion 29
Chapter Seven: Recommendation 30
Chapter Eight 31
Reference 31
Appendices and Questioner 35

8
 1. Introduction

Obesity is a complex disorder involving an excessive amount of body fat.

Obesity isn’t just a cosmetic concern. It increases the risk of several
diseases and health problems, such as heart disease, diabetes mellitus
and high blood pressure.

Although there is genetic, behavioral and hormonal influences on body

weight, obesity occurs when you take in more calories than you burn
through exercise and normal daily activities. The body stores these excess
calories as fat. Some of the causes are inactivity, unhealthy diet and eating
habits and sometimes obesity can be traced to a medical cause, such as
Prader-Willi syndrome, Cushing’s syndrome and other conditions. Certain
medication may cause weight gain or change in body composition these
include insulin, sulfonylureas and antidepressants.

From previous studies in 1997 the WHO formally recognized obesity as a

global epidemic, researchers have found that prevalence of obesity has
increased across the globe in particular in Africa, in study of prevalence of
obesity in Sudan on 7239 individuals the result showed that the prevalence
of obesity was found to be 21.2%, with a higher rate of obesity in females
than males (26.3% versus 13.8%). Central obesity was also higher in
women (36.7%) than men (17.6%). The overall prevalence of obesity was
56.1%. Obesity and central obesity have a higher prevalence among
Sudanese women.

9
2. Justification:

2.1 Topic selection:

Due to the rising prevalence of obesity and it’s many of obesity and its many
adverse effects on health that leads to death it’s being recognized as a serious
worldwide health problem, so it’s important and very interesting for study.

2.2 Selection of study area:

- Proximity.

- Due to the diversity of university community and their different view of

understanding of the issue it’s interesting to gather information from this area and
do the study.

10
3. Objective:

3.1 General objective:

To assess the degree of knowledge of female students of Omdurman Islamic

university about obesity, January- 2018

3.2 Specific objective:

3.2.1 To identify causes of obesity.

3.2.2 To assess the knowledge about obesity risk on health and its related diseases.

3.2.3 To identify complication of obesity.

11
 LITRETURE REVIEW

Obesity is defined as accumulation of excess fat in body, which is

associated with adverse health outcomes; it has become a global problem
affecting all societies and age groups. There is an increase prevalence of
obesity among adults, adolescents and children in developed as well as
developing countries. Increased prevalence of obesity gives rise to
increase in obesity associated morbid factors such as hypertension,
diabetes, dyslipidemia, obstructive sleep apnea, degenerative arthritis and
cancers. These associated co-morbid factors invariably increase the health
care expenditures of subjects with obesity and complications associated
with obesity.
Obesity is defined as having a body mass index (BMI) of 30 or more. BMI is
a calculation that takes a person’s weight and height into account.
However, BMI does have some limitations. According to the CDC, “factors
such as age, sex, ethnicity, and muscle mass can influence the relationship
between BMI and body fat. Also, BMI doesn’t distinguish between excess
fat, muscle, or bone mass, nor does it provide any indication of the
distribution of fat among individuals.”
Despite these limitations, BMI continue to be widely used as an indicator of
excess weight.

12
Causes of obesity

Eating more calories than you burn in daily activity and exercise causes
obesity. Over time, these extra calories add up and cause you to gain
weight, common causes are; eating a poor diet of foods high in fats and
calories, having a sedentary lifestyle, not sleeping enough, which can lead
to hormonal that make you feel hungrier and crave certain high- calorie
foods, also genetic, which can lead affect how your body processes food
into energy and how fat is stored, growing older, which can lead to less
muscle mass and a slower metabolic rate, making it easier to gain weight,
and weight gained during pregnancy can be difficult to lose and may
eventually lead to obesity.
Certain medical conditions may also lead to weight gain. These include:
• (PCOS): a condition that causes an imbalance of female reproductive
hormones
• Prader- Willi syndrome : a rare condition that an individual is born
with which causes excessive hunger
• Cushing syndrome: a condition caused by having excessive amount
of the hormone cortisol in your system
Who is at risk of obesity?

A complex mix of genetic, environmental, and psychological factors

can increase a person’s risk for obesity.
Your environment at home, at school, and in your community, can all
influence how and what you eat and how active you are. Maybe
haven’t found a good place to play, walk, or run.

13
 Depression can sometimes lead to weight gain, as people turn to
food for emotional comfort. Certain antidepressants can also increase
risk of weight gain. Medication such as steroids or birth control pills
can also put you at greater risk for weight gain.
How is obesity diagnosed?
Body mass is a rough calculation of a person’s weight in relation to
their height. Other more accurate measures of body fat and body fat
distribution include skinfold thickness, waist-to-hip comparisons, and
screening tests such as ultrasound, computed tomography (CT), and
magnetic resonance imaging(MRI) scans.
A measurement of the fat around your waist is also a good predictor
of risk for obesity-related diseases.
Complications of obesity:
Obesity leads to much more than simple weight gain. Having a high
ratio of body fat to muscle puts strain on your bones as well as your
internal organs. It also increases inflammation in the body, which is
thought to be cause of cancer.
It causes:
• Type 2 diabetes
• Heart disease
• High blood pressure
• Stroke
• Gallbladder disease
• Fatty liver disease
• High cholesterol
• Sleep apnea and other breathing problems

14
• Arthritis
How is obesity treated?
By lifestyle and behavior changes, the healthcare team can educate
the individual on better food choices and help develop a healthy
eating plan that can work. A structured exercises program and
increased daily activity – up to 300 minutes a week- will help building
strength, endurance, and metabolism.
Counseling or support group may also identify unhealthy triggers and
help to cope with any anxiety, depression, or emotional eating issues.
Medical weight loss
Medications are usually prescribed only if other methods of weight
loss haven’t worked and if you have BMI of 27 or more in addition to
obesity – related health issues. Prescription weight loss medications
either prevent the absorption of fat or suppress appetite.

Weight loss surgery

Weight loss surgery (commonly called “bariatric surgery”) requires a
commitment from patients that they will change their lifestyle. This
type of surgery work by limiting how much food you can comfortably
eat or by preventing your body from absorbing food and calories.
Sometimes they do both.

Surgical options include:

• Gastric bypass surgery, which creates a small pouch at the top of the
stomach that connects directly to your intestine. Food and liquids go
through the pouch and into the intestine, bypassing most of the
stomach.

15
• Laparoscopic adjustable gastric banding (LAGB), which separates
the stomach into tow pouches using a band.
Preventing obesity:
Help prevent weight gain by making good lifestyle choices. Aim for
moderate exercise (walking, swimming, and biking) for 20 to 30
minutes every day. Eat well by choosing nutritious foods like fruits,
vegetables, whole grains, and lean protein, and eating high-fat, high –
calorie food in moderation.

16
 Previous study:

The World Health Organization (WHO) estimates, that more than 1.7
million of the world population is overweight and 310 million are obese.
The rates of obesity have tripled in the last 10 years in developing
countries. These increased rates were observed especially in the Middle
East, China and south East Asia. Obesity in Sudan study on 7239
individuals the result showed that the prevalence of obesity was found to
be 21.2%, with a higher rate of obesity in females than males (26.3%
versus 13.8%). Central obesity was also higher in women (36.7%) than
men (17.6%). The overall prevalence of obesity was 56.1%. Obesity and
central obesity have a higher prevalence among Sudanese women.

17
 4 Material and method

4.1 Study design:

This is a descriptive cross-sectional school based study.

4.2 Study area:

4.2.1: location:

Omdurman Islamic university located in Althawarha alharah al-wola in Omdurman

city, the campus is for female students only. It’s composed of 12 faculty like
Arabic language faculty, Science and technology, Islamic science and faculty of
Media.

4.3 Study population:

Female students of Omdurman University

4.4 selection criteria:

4.4.1 Inclusion criteria:

Female students who are willing to participate in the study

4.4.2 Exclusion criteria:

Male students, teachers, staff, workers, and female students unwilling to

participate in the study

18
4.5 Data collection:

Data was collected by closed ended pre- tested questionnaire, which has been
modified to fit the objectives of this study.

4.6 Sample size:

100 females selected randomly.

4.7 Ethical Consideration:

Verbal ethical consent was taken from females.

19
 Results:

60
52
50
Number of study participants

40

30
25

20 17

10 6

0
16-20 years old 21-24 years old 25-30 years old Over 30

Figure 1:

Age distribution of females in study about knowledge of obesity and related health problems January,
2018: (n=100)

20
 100
89
90

80
Number of study participants

70

60

50

40

30

20
8
10 3
0
Single Divorced Married

Figure 2: shows the distribution of the study of knowledge of obesity and related health problems by
marital status in Omdurman Islamic university January, 2018: (n=100)

21
 Do you know what is obesity?

18%

Yes
No

82%

Figure 3: shows the distribution of the study of knowledge of obesity and related health problems
that know what obesity means in Omdurman Islamic university January, 2018: (n=100)

22
 90 84
80
Number of study participants

70

60

50

40

30

20 16

10

0
Increase body mass and accumilation of fats Other

Figure 4: shows what is obesity according to the study of knowledge of obesity and related health
problems in Omdurman Islamic university January, 2018: (n=100)

23
 Moving too little 59

Unhealthy Food 48

Eating too much 43

Eating Fast Food 39

Don't know 1

0 10 20 30 40 50 60 70
Number of study participants

Figure 5: shows what causes obesity according to the study of knowledge of obesity and related
health problem in Omdurman Islamic university January, 2018: (n=100)

24
 Heart Disease 65

Arteriosclerosis 51

Shortnes of breath 47

Diabetes 30

Hypertension 27

0 10 20 30 40 50 60 70
Number of study participants

Figure 6: shows the dangers of obesity according to the study of knowledge of obesity and related
health problems in Omdurman Islamic university January, 2018: (n=100)

25
 Does obesity prevent you from living your
life normally?

17%

Yes
No
Don't Know
24% 59%

Figure 7: shows the participants who say obesity prevent them from living normally according to the
study of knowledge of obesity and related health problems in Omdurman Islamic university January,
2018: (n=100).

26
 Do you eat while watching T.V.?

40%

Yes
No

60%

Figure 8: shows the portion of participants that eat while watching television in the study of
knowledge of obesity and related health problems in Omdurman Islamic university January, 2018:
(n=100)

27
 50
45
45

40
Number of study participants

35
29
30
26
25

20

15

10

0
2 meals 3 meals Over 3 meals

Figure 9: shows the number of meals per day eaten by the participants in the study of knowledge of
obesity and related health problems in Omdurman Islamic university January, 2018: (n=100)

28
 60

49
50
Number of study participants

40
33

30

20 18

10

0
Both Fast Food Home cooked

Figure 10: shows the types of meals preferred by the participants in the study of knowledge of obesity
and related health problems in Omdurman Islamic university January, 2018: (n=100)

29
 70
65

60
Number of study participants

50

40

30 26

20

9
10

0
Sometimes Always Never

Figure 11: shows the frequency of the study participants eat Fast Food in the study of knowledge of
obesity and related health problems in Omdurman Islamic university January, 2018: (n=100)

30
 Do you think it is possible to get rid of
obesity?

17%

Yes
No

83%

Figure 12: shows the portion of participants that think it is possible get rid of obesity in the study of
knowledge of obesity and related health problems in Omdurman Islamic university January, 2018:
n(100)

31
 Exercise 72

Dieting 50

Surgery (gastric bypass or sleeve) 4

Drugs 3

Does not know 2

0 10 20 30 40 50 60 70 80
Number of study participants

Figure 13: shows how to get rid of obesity according to the participants in the study of knowledge of
obesity and related health problems in Omdurman Islamic university January, 2018: (n=100)

32
 Do you exercise?

42%
Yes
No
58%

Figure 14: shows the portion of the participants that exercise in the study of knowledge of obesity and
related health problems in Omdurman Islamic university January, 2018: (n=100)

33
 45 42
40
Number of study participants

35 32
30
24
25

20
14
15

10

0
Zomba Jumping rope Swimming Volleyball

Figure 15: shows the type of exercise practiced by participants in the study of knowledge of obesity
and related health problems in Omdurman Islamic university January, 2018: (n=100)

34
 Discussion

This study aimed to detect the knowledge about obesity and related health problems in
female students of Omdurman Islamic university, January 2018.

The participants were 100. The result reveals that age group (21-24) shows the highest
percentage of the study group (52%), comparing with other age groups and (30 and
above) show the minimum percentage (6%) [Figure: 1].

Regarding to marital status single show the highest percentage (89%), comparing with
married (8%), while divorced participant show the minimum percentage (3%) [Figure: 2].

Knowledge of population about meaning of obesity reveals that (82%) knows the
meaning of obesity while (18%) didn’t know what obesity means. [Figure: 3].

The percentage of participant who defined obesity as an increase in body mass and
accumulation of fat was the highest by (84%) while other definition was(16%)[Figure: 4].

Knowledge of population about cause of obesity show that lack of movement was the
highest percentage (59%) in comparing to unhealthy food (48%), eating too much
(43%), eating fast food (39%), (1%) of population didn't know what are the causes of
obesity [Figure :5]. So it was found that knowledge about causes of obesity was
seemed to be so far good.

About health problems caused by obesity heart disease was found to be the highest
percentage according to the participants opinion by (65%), Arteriosclerosis(51%),
shortness of breath(47%) comparing to diabetes and hypertension (30%),(27%)
respectively. [Figure: 6].

Percentage of participants who think obesity prevent them from living normally is (59%)
while (24%) of participants didn’t think obesity prevent them from living a normal life,
(17%) didn’t know. [Figure: 7].

Most of participants eat while watching TV (60%) versus (40%) doesn’t eat while
watching TV. [Figure: 8].

35
Most of the participants said they were eating two meals per day (45%), (29%) of the
participants eating three meals per day, while (26%) of the participants eating more than
three meals [Figure: 9].

(49%) of participants preferred eating from both home cooked and fast food while fast
food showed the highest percentage (33%) comparing to home cooked food (18%)
[Figure: 10].

Most of the participants said that they sometimes eat fast food (65%), (26%) of the
participants always eat fast food, while (9%) of participants never eats fast food
[Figure: 11].

Percentage of the participants said that it’s possible to get rid of obesity (83%) is larger
comparing to percentage of participants said that it’s not possible to get rid of obesity
(17%) [Figure: 12].

Regarding the methods of getting rid of obesity, exercise showed the highest
percentage (72%) followed by dieting (50%), surgery (4%), drugs (3%), while (2%) of
participants didn’t know how to get rid of obesity. [Figure: 13].

According to exercises practicing (58%) of participants does exercise while (42%)

doesn’t exercise. [Figure: 14].

Regarding type of exercise and sport (42%) of the participants practice Zumba, (32%) of
participants practice rope jumping, (24%) of the participants do swimming, while (14%)
practice volleyball sport. [Figure: 15].

36
 CONCLUSION

This study has been done in Omdurman Islamic University, to estimate the
knowledge of females about obesity and related health problems, the result
revealed that their ages varied between 16-30 years old, moving too little or
inactivity was agreed by more than half of females as cause of obesity. According
to the opinion of females about if obesity prevent them from living a normal life
was found greater than half in .Eating while watching TV shows highest
percentage as a source of information, and majority of females think that it’s
possible to get rid of obesity . Regarding the type of exercises that females
practice, volleyball showed less preferred type of exercise while majority of the
target group practice Zumba more often.

37
 Recommendation

In this research the following is recommended:

(1) Increase knowledge about obesity by educational programs about health

disease of obesity and how to prevent it.

(2) Encourage healthy diet and eating habits.

(3) Increase burning of calories by doing appropriate amount of exercises

regularly.

38
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41
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42
 ‫بسم هللا الرحمن الرحيم‬

‫جامعة العلوم والتقانة‬

‫كلية الطب‬

‫قسم طب المجتمع‬
‫إستبيان عن األضرار الصحية للسمنة‬
‫إسم الباحثة‪ :‬سمية حافظ أحمد حسب القوى‬
‫هذا اإلستبيان سري بغرض البحث العلمى فقط‬
‫‪ -1‬كم عمرك‪:‬‬
‫‪16-20 -‬‬ ‫) ب‪/‬‬ ‫) ج‪( 21-24 /‬‬ ‫) د‪ /‬أكثر من ‪( 25 -30‬‬ ‫( ‪(30‬‬
‫)‬
‫‪ -2‬الحالة اإلجتماعية‪:‬‬
‫)‬ ‫) ج‪ /‬مطلقة (‬ ‫(‬ ‫) ب‪ /‬متزوجة‬ ‫أ‪ /‬عازبة (‬
‫‪ -3‬هل تعرفين معني البدانة ؟‬
‫)‬ ‫ب‪ /‬ال (‬ ‫)‬ ‫(‬ ‫أ‪ /‬نعم‬
‫‪ -4‬تعريف البدانة هو‪:‬‬
‫)‬ ‫تراكم الدهون وزيادة في حجم الجسم (‬
‫أو هي ‪ :‬أجيبي ‪:‬‬
‫‪..................................................................................‬‬
‫‪ -5‬ماهي األسباب التي تؤدي الي البدانة ؟‬
‫)‬ ‫أ‪ /‬االكل غير الصحي (‬

‫‪43‬‬
 ‫)‬ ‫(‬ ‫ب‪ /‬كثرة االكل‬
‫)‬ ‫(‬ ‫ج‪ /‬قلة الحركة‬
‫)‬ ‫د‪ /‬تناول الوجبات السريعة (‬
‫)‬ ‫ه‪ /‬ال أعرف (‬
‫‪ -6‬ماهي مخاطر البدانة ؟‬
‫)‬ ‫(‬ ‫أ‪ /‬أمراض القلب‬
‫)‬ ‫(‬ ‫ب‪ /‬تصلب الشرايين‬
‫)‬ ‫(‬ ‫ج‪ /‬مرض السكري‬
‫)‬ ‫د‪ /‬ارتفاع ضغط الدم (‬
‫)‬ ‫(‬ ‫ه‪ /‬صعوبة التنفس‬
‫‪ -7‬هل تمنع البدانة االشخاص من ممارسة حياتهم بشكل طبيعى ؟‬
‫)‬ ‫ج‪ /‬ال أعرف (‬ ‫)‬ ‫(‬ ‫ب‪ /‬ال‬ ‫)‬ ‫(‬ ‫أ‪ /‬نعم‬
‫– هل تحب تناول الطعام أثناء مشاهدة التلفاز ؟‪8‬‬
‫)‬ ‫(‬ ‫ال‬ ‫ب‪/‬‬ ‫)‬ ‫(‬ ‫أ‪ /‬نعم‬
‫‪ -9‬كم عدد الوجبات التي تتناولها في اليوم ؟‬
‫) ب‪/‬‬ ‫(‬ ‫) أ‪ /‬وجبتان‬ ‫) ج‪ /‬أكثر من ثالثة وجبات (‬ ‫وجبات (‬
‫‪ -10‬ايهما تفضل طعام المنزل أم الطعام الخارجي ؟‬
‫)‬ ‫) ج‪ /‬األثنان معا (‬ ‫الخارجي (‬ ‫ب‪/‬‬ ‫)‬ ‫أ‪ /‬المنزل (‬
‫‪ -11‬هل تتناول الوجبات السريعة ؟‬
‫)‬ ‫) ج‪ /‬ال أتناول الوجبات السريعة (‬ ‫) ب‪ /‬أحيانا (‬ ‫أ‪ /‬دائما (‬
‫‪ -‬هل يمكن أن نتخلص من البدانة ؟‪12‬‬
‫‪44‬‬
‫)‬ ‫ب‪ /‬ال (‬ ‫)‬ ‫(‬ ‫أ‪ /‬نعم‬
‫‪ -13‬يمكن أن نتخلص من البدانة بالطرق األتية‪:‬‬
‫)‬ ‫(‬ ‫أ‪ /‬ممارسة الرياضة‬
‫)‬ ‫(‬ ‫ب‪ /‬اتباع حمية غذائية " الرجيم "‬
‫)‬ ‫(‬ ‫ج‪ /‬األدوية‬
‫)‬ ‫د‪ /‬العمليات الجراحية " ربط المعدة " (‬
‫)‬ ‫ه‪ /‬ال أعرف (‬
‫‪ -14‬هل تمارسين الرياضة ؟‬
‫)‬ ‫(‬ ‫ب‪ /‬ال‬ ‫)‬ ‫(‬ ‫أ‪ /‬نعم‬
‫‪15-‬‬ ‫‪15‬نوع الرياضة المفضل‪:‬‬
‫)‬ ‫(‬ ‫ب‪ /‬كرة اليد‬ ‫)‬ ‫(‬ ‫أ‪ /‬الزومبا‬
‫)‬ ‫(‬ ‫د‪ /‬السباحة‬ ‫)‬ ‫ج‪ /‬القفز بالحبل (‬

‫‪45‬‬
46