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PubMed2004

Phenotypic and genotypic identification of Aeromonas spp. isolated from a chlorinated intermittent water distribution system in Lebanon.

Aeromonas spp. were detected in samples collected from both untreated groundwater and treated drinking water in Lebanon. Aeromonas spp. levels ranged between 2 and 1,100 colonies per 100 ml in the intake underground well and between 3 and 43 colonies per 100 ml in samples from the distribution system. Samples positive for Aeromonas spp. from the network had a free chlorine level ranging between 0 and 0.4 mg l(-1). Multiple antibiotic-resistance was common among the isolated aeromonads; all were resistant to amoxycillin while 92% showed resistance to cephalexin. Haemolysis on blood agar was detected in 52% of the isolates recovered from the distribution network and 81% of isolates from the untreated underground source. The Biolog microbial identification system assigned identities to all of the isolated presumptive aeromonads (at least at the genus level), which was not the case with the API 20NE strips. Differences at the species level were observed when results from the Biolog system were compared with identification based on the MicroSeq 500 16S rDNA sequence analysis. The presence of Aeromonas spp. in drinking water can be an important threat to public health, thus greater awareness of Aeromonas strains as potential enteropathogens is warranted.

Aeromonas↗
PubMed2004

[Epidemiology of parasitic diseases in military personnel treated in the United Nations Interim Force hospital in Lebanon, from 1993 to 2000].

The study examined the incidence and prevalence of parasitic diseases among military personnel of the United Nations Interim Force in Lebanon (UNIFIL) and local civilian population. Additionally, the authors investigated the potential risk factors, including environmental conditions, influencing the incidence of infectious diseases. Epidemiological analysis was conducted based on the medial records of patients treated in the Internal and Surgical Ward of the UNIFIL Hospital from 1993 to 2000. The patients with parasitic diseases accounted for 3.78% of all patients hospitalized during the analyzed period. The most frequent infectious diseases treated during that time were trichuriasis, ancylostomiasis, giardiasis and ascariasis.

Adult↗
PubMed2004

[Infectious diseases among military personnel in the catchment area of the United Nations Interim Force in Lebanon hospital, from 1993 to 2000].

In the study the incidence of infectious diseases among military personnel of the United Nations Interim Force in Lebanon and local civilian population is examined. Additionally, the authors investigate the potential risk factors, including environmental conditions, influencing the incidence of infectious diseases. Epidemiological analysis was conducted based on the medical records of patients treated in the Internal and Surgical Ward of the UNIFIL Hospital from 1993 to 2000. The patients with infectious diseases accounted for 5.84 % of all patients hospitalized during the analyzed period. The most frequent infectious diseases treated during that time were salmonellosis and staphylococcal food poisoning.

Adult↗
PubMed2004

Osteoporosis a disease for all; in Lebanon.

Osteoporosis is the most important metabolic disease leading to fracture and high mortality morbidity rates. With the increase of aging population, mainly in the developing work, it is estimated that the incidence of fracture will rise too. Osteoporosis known in the past to be a woman disease, it is now accepted that it affects man too. The risk factors for osteoporosis are known now, but one vertebral fracture, leading to more vertebral fractures and increasing the risk of hip fracture, stands by itself as an independent risk factor for osteoporosis even if BMD is normal or osteopenic. Vertebral fracture is associated with high mortality rate. At the same time it is work noting that osteoporosis in man is different than in women and finally we have now the means to diagnose correctly the disease, evaluate the fracture risk, treat and monitor the treatment. But incidence, fracture rate, peak bone mass in Lebanon are different than the European or North American one.

Adult↗
PubMedDate not supplied

Bilateral percutaneous stent implantation in the pulmonary vasculature: a modality now available in Lebanon.

We report a child with Truncus Arteriosus who developed bilateral proximal branch pulmonary stenosis, following total surgical repair of her condition with construction of the right ventricular outflow tract utilizing a Contegra conduit (Medtronic Inc., Minneapolis, Minn.). The obstruction was relieved completely utilizing bilateral percutaneous stent implantation. To the best of our knowledge, this is the first reported case of bilateral stent implantation to relieve branch pulmonary artery stenosis in Lebanon. This technique could be applied to similar cases of obstruction in the pulmonary tree.

Child, Preschool↗
PubMed2004

[Features of the Arab health service as exemplified in Lebanon].

The Arab health service profile on Lebanon example, one of the Middle East countries is presented in this article. Nowadays the world becomes a global village, a free flow of people appears, who travel professionally as well as touristically. In situations of health and life hazards, in cases of diseases and injuries caused by traumas arisen in foreign countries it seems to be important to get to know problems concerning a health service condition in the region of the world being a place of work or rest. For a long time region of the Middle East have been situated in the center of interests of the world public opinion. On the one hand it is an attractive place because of tourist reasons, on the other hand take place an escalation of military conflicts in individual Arab and Muslim countries. Because of this situation permanent information on the subject of health care status in the countries of temporary stay where occurs unstable political and military situation it seems to be a necessity.

Community Health Services↗
PubMedDate not supplied

[Typhoid fever in north Lebanon: a 8-year study (1992-1999) using the Widal test].

We evaluated the frequency of typhoid fever in north Lebanon over an 8-year period (1992-1999) in patients admitted with fever to the Islami de Bienfaisance Hospital in Tripoli. We analysed 7391 serum samples for Salmonella typhi infection using the Widal and Felix tests. The cut-off value for infection was an agglutinin O titre > or = 1/160 (a value validated in an earlier study in the same region). Of the 7391 samples, 1131 (15.3%) had an agglutinin O titre > or = 1/160. The 8-year surveillance showed there was a progressive decrease in the frequency of the disease. However with over 100 cases annually, typhoid is endemic in the area and could cause major outbreaks. The monthly analysis shows that we have an increase in summer, whilst a decrease is observed in winter.

Agglutination Tests↗
PubMed2004

Patterns of antenatal care in low-versus high-risk pregnancies in Lebanon.

We studied patterns of antenatal care in low- versus high-risk pregnancies in Lebanon comparing 538 women after delivery in urban Beirut with rural Baka'a. Most women had 9 antenatal care visits with an obstetrician, starting in the first trimester. Care for high-risk and low-risk pregnancies was similar in terms of type of provider, number of visits and timing of first visit. More high-risk women had advice about special diets, supplements and laboratory tests. Maternal and fetal outcomes showed that, controlling for area and pregnancy risk, more antenatal visits were associated with fewer preterm deliveries, more caesarean sections and fewer cases of postpartum depression. Overall, differences between risk groups were small.

Adult↗
PubMed1980

Renal lithiasis in Lebanon: I--the chemical types of urinary calculi.

The results of chemical analyses of 429 urinary calculi are presented and classified according to chemical composition. Some of the general features of the different chemical types of the stones are discussed. Although the general distribution of the chemical types of stones in Lebanon is essentially similar to that reported from other countries, the two striking features of this series are: (1) a relatively lower incidence of infection stones (i.e. stones containing magnesium ammonium phosphate) and (2) a relatively higher incidence of stones containing a mixture of uric acid and calcium oxalate and/or calcium phosphate.

Calcium Oxalate↗
PubMedDate not supplied

Factors influencing the choice of specialty among medical students in Lebanon.

STATEMENT OF THE PROBLEM: We focus on graduating students from two medical schools in Lebanon to identify the proportions who select primary care careers, to highlight factors that are considered when making a career choice, and to compare these among primary care (PC) and non-primary care (NPC) candidates. METHODS: Anonymous self-administered questionnaire was used to assess student demographics, chosen career, and perceived level of importance concerning 27 career influencing factors using a 5-point Likert scale. RESULTS: 127 (97%) students responded. 53 (42%) students selected primary care. 20 (61%) of the females were in the primary care group. Among all, the most important factors scored (3.30 to 3.06) represent: "intellectual opportunities", "match of personal interest and skills" and "helping and social responsibilities". Least important factors scored (1.96 to 1.13) and represent: "encouragement/role models", "clerkships and courses", and "residency issues". "Diversity in diagnosis and treatment" and "emphasis on patient education and prevention" were significantly higher for the primary care career groups (p = 0.001, p = 0.001) and "working with new technology" significantly more important (p = 0.001) for the non-primary care group. CONCLUSION: Among the students surveyed "intellectual opportunities", "match of personal interest and skills" and "helping and social responsibilities" were the most important criteria reported to influence their choice of career in medicine.

Adult↗
PubMed2006

Nationwide study of drug resistance among acid-fast bacilli positive pulmonary tuberculosis cases in Lebanon.

OBJECTIVE: To assess the prevalence of drug resistance among smear-positive sputum specimens from pulmonary tuberculosis (TB) cases in Lebanon. DESIGN: Between July 2002 and April 2004, 224 newly diagnosed TB cases and 21 previously treated TB cases were collected nationwide. Mycobacterium tuberculosis isolates were tested against isoniazid (INH), rifampicin (RMP), streptomycin (SM) and ethambutol (EMB) using the BACTEC-TB system. RESULTS: M. tuberculosis and non-tuberculous mycobacteria (NTM) isolates were recovered from 190 and 15 new cases, respectively, and from 16 and 1 previously treated cases, respectively. Overall drug resistance among new TB vs. previously treated TB cases was 19.5% and 75%, and for single drugs it was INH (12% vs. 63%), RMP (3% vs. 56%), SM (12% vs. 44%) and EMB (3% vs. 44%). The overall rate of multidrug resistance (MDR) was 5.8% (1% vs. 62.5%). The male:female ratio was 1.3:1; most were young adults. CONCLUSION: Relatively moderate single drug resistance and very low MDR rates were found among new TB cases, while among previously treated TB cases very high resistance and MDR resistance rates were detected. Such findings underline the need for ongoing stringent control measures to curb the spread of M. tuberculosis and its deleterious effects.

Adult↗
PubMedDate not supplied

Adherence to universal precautions among laboratory personnel in Lebanon.

To evaluate the present situation and plan future directions with regard to implementation of universal precautions in laboratories testing blood samples, we carried out a national cross sectional study in 2003 on a representative sample of laboratories in Lebanon. We compared the results with those of a 1993 study. We found that the education profile of staff had improved, being now more specialized in laboratory science. The discrepancies between what technicians knew, believed in and practised and what was observed in the field improved to some extent in most variables. Disposal of needles and syringes had improved greatly but disposal of blood-contaminated material had not. Given the risks of improper practice, a policy of universal precautions is essential and regular training should be carried out so that staff know and practise the universal precautions and correct laboratory procedures.

Attitude of Health Personnel↗
PubMedDate not supplied

[Clinical pharmacy in lebanon: a pilot study regarding health care professionals' opinion].

INTRODUCTION: In Lebanon, clinical pharmacy is not professionally applied, despite being taught and required by the accreditation system of hospitals established by the Ministry of Health. The objective of our study is to evaluate the knowledge and attitude of medical professionals regarding the concept of clinical pharmacy. METHODS: It is a descriptive cross-sectional study, conducted in hospitals with doctors, nurses and administrators. Standardized self-filling questionnaires were distributed. RESULTS: The majority of physicians and of nurses found a clinical pharmacist intervention beneficial. All administrators were ready to accept a clinical pharmacist in their institution, since his/her presence would contribute to the reduction of hospitalization costs, mortality and morbidity. DISCUSSION: Medical professionals have a clear and positive idea regarding clinical pharmacy. CONCLUSION: Different steps are necessary in order to integrate clinical pharmacy in the Lebanese health care system.

Attitude of Health Personnel↗
PubMed2006

The use of medical informatics as a management tool for community health services during the 2006 Israel-Lebanon War.

BACKGROUND: During war the health management organizations have tremendous difficulty monitoring members' needs according to geographic spread. OBJECTIVES: To describe how an HMO used its health information technology in a way that enables its management to receive updated online information on the needs of the insured, according to their distribution throughout the country during the time of the war in Lebanon in July-August 2006. METHODS: Data were derived from the computerized medical records of Maccabi Healthcare Services--the second largest HMO in Israel, providing care to more than 1.7 million members nationwide. Data on healthcare utilization by northern members were compared to the geographic distribution of clinics. RESULTS: The war was characterized by the massive evacuation of citizens southwards. During this period there was an abrupt decline in the utilization of medical services by northern members in the northern region. This decline returned to normal 10 days after the ceasefire. A reciprocal increase was noted in the use of health services by citizens from the north in other regions. This increase returned to normal after the war. No such pattern was noticed during the same period in 2005. CONCLUSIONS: Real-time surveillance of trends in consumption of health services by citizens in times of regular daily living as well as during emergencies and wars is a vital management tool for medical directors responsible for providing health services.

Catchment Area, Health↗
PubMed1990

[Prevalence and incidence of diabetes mellitus in Lebanon].

In order to evaluate the occurrence of diabetes mellitus in Lebanon, 8,050 cases were studied and divided into two samples; the first one was formed by external patients applying to a laboratory for biological tests and the second one was evaluated retrospectively on patients records hospitalized between the year 1970 and 1985. The prevalence evaluated in the hospital environment was 5.0% and the incidence varied from 1.5 to 1.7% according to the different samples; these values were similar to the international average results.

Adolescent↗
PubMed1990

Burns in the Lebanon War 1982: "the blow and the cure".

There were 70% more burns in the October 1973 war than in the Six Day War of 1967. This increase caused great concern and emphasized the need for better personal and crew protection against burns. Some of these measures were already implemented by the outbreak of the 1982 war in Lebanon. Analysis of the burn injuries of this war is the subject of this short report.

Burns↗
PubMed1990

Wartime neurosurgical experience in Lebanon, 1982-85. II: Closed craniocerebral injuries.

This report presents 64 patients who sustained military-related closed craniocerebral injuries during the Lebanon conflict of 1982-85, all of whom underwent CT scanning at the initial assessment. Of these, 59% required surgery for removal of hematomas, depressed fractures and for monitoring intracranial pressure, in addition to intensive care management of elevated intracranial pressure and associated insults. CT scan revealed brain concussion only in 23%, depressed fracture in 9%, brain contusion alone in 17%, extracerebral hematomas in 17%, intracerebral hematomas in 11%, and diffuse axonal injury in 22%. Overall mortality was 19%, and the outcome was good in 69%. Various factors affecting survival are discussed, and our findings are compared with those in the literature concerning closed head injuries among civilians. Attention is drawn to the high proportion of diffuse brain injury due to blasts caused by side mines. Despite continued efforts to hasten evacuation from the field and improve the management of warfare-related head trauma, the outcome is still far from satisfactory.

Blast Injuries↗
PubMed1988

Polymorphism of immunoglobulin lambda constant region genes in populations from France, Lebanon and Tunisia.

Polymorphism of immunoglobulin lambda constant region (IGLC) genes has been studied in French, Lebanese and Tunisian people. The human IGLC polymorphisms appear as EcoRI restriction fragment length variations-8, 13, 18 or 23 kb-, these polymorphic fragments being related to a number of IGLC genes varying from six to nine per haploid genome. DNAs digested with the endonucleases EcoRI and HindIII were hybridized to a human IGLC probe and an immunoglobulin lambda intervening sequence region probe containing the J lambda 2 gene segment. Restriction fragments detected in Southern hybridizations were assigned to the IGLC locus map. Family studies allowed us to confirm the allelic nature of four of the different EcoRI restriction fragments observed. Frequencies of the corresponding alleles in French, Lebanese and Tunisian populations were determined and compared. The decrease of the 8-kb fragment (allele A1) frequency and, conversely, the increase of that of the 13-kb and 18-kb fragments (alleles A2 and A3) seemed to be correlated to a Negroid African contribution in the gene pool more important in Tunisia than in Lebanon.

Deoxyribonuclease EcoRI↗