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The questionnaire collected risk factors for cardiovascular disease, including demographic and background characteristics, medical history (including family history of coronary artery disease in first-degree relatives), behavioral risk factors (khat chewing, smokeless tobacco, waterpipe smoking, and cigarette smoking), and medical risk factors (lipid profile, hypertension, diabetes mellitus, fasting blood glucose, waisthip ratio, and physical activity)

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The thickening may represent hyperkeratosis (or increased thickening of the outer layer of the skin) as well as atypical skin cells present in the skin