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PubMed1981

Salmonella agona isolated from fish meal and a Salmonella strain isolated from shrimps in Lebanon.

Salmonella agona was isolated from an imported fish meal specimen and a Salmonella strain not listed in the Kauffmann-White Scheme was isolated from a shrimp specimen obtained from the Mediterranean coast of Lebanon. The biochemical and serological properties of the S. agona fish meal strain was identical to a standard strain. The serotype of the shrimp strain was O13,22 Vi. With the exception of hydrogen sulfide production the biochemical properties of the shrimp strain were similar to S. agona.

Agglutination Tests↗
PubMed1981

Sandhoff disease: a prevalent form of infantile GM2 gangliosidosis in Lebanon.

All cases clinically diagnosed as Tay-Sachs disease at the American University Hospital, Beirut, during a period of 22 years (1957--1979) were reviewed. Of a total of 15 cases, seven had serum hexosaminidase tested and proved to have Sandhoff disease. In two other cases, parents were tested and found to be Sandhoff carriers. These results indicate that Sandhoff disease is relatively prevalent in Lebanon and that it may represent the more common form of infantile GM2 gangliosidosis in this country.

Diagnosis, Differential↗
PubMedDate not supplied

A comparison of pregnancy care delivered by family physicians versus obstetricians in Lebanon.

BACKGROUND: The provision of prenatal and intrapartum care is an important issue in family practice. Physician specialty as a risk factor for adverse perinatal outcome is of interest to both educators and patients. The purpose of this study is to compare perinatal care provided by family practice and obstetrics residents for low-risk women in Lebanon. METHODS: A study of 400 matched pairs of low-risk pregnant women was conducted at the American University of Beirut Medical Center to compare outcomes of perinatal care provided by family physicians and obstetricians. The medical records of women admitted for delivery at the American University of Beirut Medical Center between October 1, 1986, and October 1, 1990, were reviewed. RESULTS: Obstetricians used oxytocin induction significantly more frequently than family physicians (43% versus 7%, P < .01). A similar significant difference was also noted for artificial rupture of membranes. There were similar episiotomy rates (63%), with a greater number of lacerations reported among women cared for by obstetricians (28% versus 15%, P < .05). The use of forceps was similar in both groups. Vacuum extraction was not used by family physicians. Neonatal outcomes were comparable, although meconium-stained amniotic fluid was more common in the obstetrics group (21% versus 6%, P < .05). During the postpartum period, significantly more women breast-fed (62% versus 45%, P < .01) and used oral contraceptives in the family practice group. CONCLUSIONS: When caring for low-risk pregnant women, family physicians appear to provide comparable care with less intervention than obstetricians.

Adolescent↗
PubMedDate not supplied

[Intermediary hosts of Dicrocoelium lanceolatum in Lebanon and Syria (author's transl)].

The authors describe the biological cycle of the Trematoda Dicrocoelium lanceolatum in Lebanon and in Syria: two principal first hosts are the Gastropoda: Theba syriaca and Xerophila vestalis; the second intermediate host is the ant Formica (S.) rufibarbis var. clarorufibarbis very common near fresh water in herbous lands, over 1,000 m of altitude. The last host is the Sheep, the Cow and probably the Goat. A humain case is commented.

Animals↗
PubMed1996

An epidemic of hyperthyroidism following salt iodination in Lebanon.

Salt iodination, in Lebanon, started partially in late 1992, and was implemented in a uniform manner by January 1995. Following salt iodination, an epidemic of iodine-induced thyrotoxicosis occurred, as noted by the author, in his private clinic. The number of thyrotoxic patients increased sharply by 2 to 6 folds, and the yearly incidence rose from a baseline of 0.02% up to 0.07%. The younger patients have predominantly Graves' disease (32% of the cases), while 17% have solitary thyroid nodules, and 44% of the cases were elderly subjects with multinodular goiter. The pathogenesis and possible causes of this epidemic are discussed.

Adult↗
PubMed1996

Estimation of cancer incidence in Lebanon.

Cancer incidence rate is an important indicator for policymakers seeking to establish a National Cancer Control Program in Lebanon. This rate is difficult to assess, however, in view of the absence of national health and vital statistics. Fragmentary data from 1984 were used to estimate the annual cancer case-load at 3,500 cases. For an estimated population of 3.29 million, this case-load yields an incidence rate of 106 per 100,000. This low rate has not varied much since the mid-60s, and is nearer to that of developing than of developed nations. Cancer incidence may however increase in the coming few years with the aging of the population, and increasing urban pollution, smoking and adverse diet changing.

Adult↗
PubMed1996

[Validation of choice of experts for the spondylarthropathy study in Lebanon].

A study of the spondylarthropathies, their recent diagnostic criteria and the prevalence of HLA B27 in these affections in Lebanon will soon be started. Experts will have to include patients, prospectively, and to classify them as having or not a spondylarthropathy, according solely to their clinical judgement. The decision of the expert is of major importance in including patients in the study. We performed a clinical evaluation of inter-observer variability to select experts according to a significant concordance in the clinical diagnosis of different rheumatic diseases, especially spondylarthropathies. Results of the evaluation are presented and discussed.

Clinical Competence↗
PubMed1997

Earthquakes: health outcomes and implications in Lebanon.

Earthquakes remain damaging to human life and property. Recent reports point out that there is 50% chance to have a damaging earthquake in the next 50 years in Lebanon. Major health outcomes of earthquakes include physical injuries, cardiovascular effects and psychological reactions. Physical injuries are correlated with entrapment, higher number of floors in buildings and behavior at time of impact. Cardiovascular effects of earthquakes are either immediate or delayed. Immediate cardiovascular effects are exemplified by increased coronary death while delayed effects are reflected by the increase in coronary risk factors such as serum triglycerides and heart rate. The severity of PTSD decreases as the distance from the epicenter of the earthquake increases. Preventive measures such as implementation of safety building codes, medical emergency readiness and public education should be carried out in areas threatened by earthquakes. Also special mental health programs should be executed following an earthquake.

Cardiovascular Diseases↗
PubMed1998

[Evaluation of the Widal test for diagnosing typhoid fever in Lebanon].

Typhoid fever is a major public health problem in developing countries. In Lebanon, where the sanitary infrastructure was severely damaged during the civil war, the high prevalence of typhoid fever creates a pressing need for a rapid and reliable diagnostic tool. To evaluate the diagnostic usefulness of the Widal test, patients with a positive blood culture for Salmonella typhi (n = 78) were compared to controls with fever due to another infection (n = 65) and with blood donors (n = 96). Discrimination between the patient group and the two control groups was best when an agglutinin O titer of 1/160 or more was used. With this cutoff, sensitivity was 67.9%; specificity was 93.8% versus the febrile controls and 100% versus the blood donors. These results suggest that despite its well-known limitations the Widal test remains a valuable tool for typhoid fever control in many developing countries.

Antigens, Bacterial↗
PubMed2001

Economic sustainability of small ruminants production in semi-arid areas of Lebanon.

Small ruminant production in the near east region is facing serious constraint of feed availability. A study was conducted in marginal areas of Lebanon, using a cost-benefit analysis technique (CBA), to assess the feasibility of four small ruminant production systems ranging from semi-nomadic to settled. When the owned labor cost was included as an opportunity cost in the economic analysis, CBA revealed negative returns in all four systems. Only the settled system was profitable according to the financial analysis excluding labor cost. Moreover, feed expenses if coupled with grazing costs represented a major constraint to profitability. To remedy to the feed deficit problem, the potential of using agro-industrial by-products as feed block supplements was investigated. Simulated feed block diets, using the most available by-products, provided a better nutritive value per unit cost than hand-fed diets used in the systems studied. Preliminary analysis showed that the use of feed block diets could improve the economic sustainability of small ruminant production systems.

Journal Article↗
PubMed1988

A follow-up of Israeli casualties of combat stress reaction ('battle shock') in the 1982 Lebanon War.

A sample of 104 Israeli soldiers diagnosed as suffering from combat stress reactions (CSR) ('battle shock') during the 1982 Lebanon War were examined by mental health clinicians a year after the war. The clinicians assessed (a) post-traumatic stress disorder (PTSD) as defined in the DSM-III (1980), (b) associated psychological symptoms (somatization, anxiety, and depression), and (c) disturbances in post-war functioning. The clinicians collected background information on sociodemographic characteristics, premilitary and military adjustment, combat experiences, and the extent of the CSR episode. The analysis indicated that PTSD could be predicted fairly well by the extent of the CSR episode and specific combat experiences, while the psychological symptoms were predicted mainly by combat experiences, and post-war functioning was predicted mainly by pre-war factors. The implication of combat experiences and soldiers' immediate reactions during combat in the genesis of subsequent PTSD is discussed. The multifaceted nature of war-related psychological sequelae is delineated.

Adaptation, Psychological↗
PubMed1998

A cytogenetic register of down syndrome in Lebanon.

OBJECTIVES: To provide data on the cytogenetics and epidemiology of Down syndrome in our community. METHODS: All cases of Down syndrome diagnosed cytogenetically were entered over a period of 5 years together with data regarding age at referral, parental ages and parity. RESULTS: A total of 280 cases were entered. In postnatal cases, the mean maternal age was 32.19 years and 41.5% of mothers were over 35 years. Only 47.3% of Down syndrome children were diagnosed at less than 1 month of age. The male to female sex ratio of 1.66 is significantly more elevated than that reported in larger registers. CONCLUSIONS: Because of problems inherent to Lebanon, this register does not have a high level of ascertainment, however it appears that the emphasis in a potential prevention programme should be placed on education, information and family planning.

Journal Article↗
PubMed2002

The influence of consanguineous marriage on infant and child mortality among Palestinians in the West Bank and Gaza, Jordan, Lebanon and Syria.

OBJECTIVES: The purpose of this paper is to explore the characteristics of mortality differences associated with consanguineous marriage among Palestinians in the Middle East. METHODS: The data came from five surveys of Palestinians living in the West Bank and Gaza, Syria, Jordan and Lebanon, conducted during the period 1995-2000. Infant and child mortality was estimated for the offspring of consanguineous and non-consanguineous parents using the synthetic cohort method. RESULTS: The data showed an increase in infant mortality of 15.0 additional deaths per 1,000 births among the offspring of first cousins, and a corresponding increase of 6.1 deaths per 1,000 for the progeny of parents from the same patrilineal clan. CONCLUSION: In populations where marriage within kin groups is common, both first cousin marriage and intra-group marriage carries an added risk of infant and child mortality.

Journal Article↗
PubMed1986

The role of proximity, immediacy, and expectancy in frontline treatment of combat stress reaction among Israelis in the Lebanon War.

The authors examined the effectiveness of the prevailing treatment doctrine stressing the principles of proximity, immediacy, and expectancy for combat stress reaction among Israeli soldiers in the Lebanon War. Two treatment outcomes were measured: return to military unit and presence of posttraumatic stress disorder. All three treatment principles were associated with a higher rate of return to the military unit. The beneficial effect of frontline treatment was also evidenced by lower rates of posttraumatic stress disorder. The authors suggest that these principles can also be effective in treating other forms of posttraumatic stress disorder.

Adolescent↗
PubMed2004

Circulating immune complexes and complement C3 and C4 levels in a selected group of patients with rhinitis in Lebanon.

BACKGROUND: A number of reports indicate that circulating immune complexes (CIC) and activation of the complement system contribute to the pathogenesis of Type I allergy. The aim of this study was to investigate the status of CIC in 113 patients with rhinitis in Lebanon and determine complement components C3 and C4 serum levels in the CIC-positive patients. Serum specific IgE antibodies were previously detected and reported in 74 of the 113 patients. METHODS: CIC were detected by polyethylene glycol precipitation and serum C3 and C4 levels quantified by radial immunodiffusion. RESULTS: CIC was positive in 20 of the specific IgE-positive and 13 of the specific IgE-negative patients. C3 and C4 levels were within the normal range in all the 33 CIC-positive patients. CONCLUSIONS: The antibody class that constitutes the complexes does not seem to be IgG or IgM. Moreover, complement activation does not seem to be involved in the allergic reaction since both C3 and C4 levels were normal in all patients. The role of these complexes, if any, in the pathogenesis of rhinitis is yet to be determined.

Journal Article↗
PubMedDate not supplied

A neonatal screening in Lebanon: Results of five years' experience.

BACKGROUND: Neonatal screening programs for common disorders like phenylketonuria, congenital hypothyroidism, and glucose-6-phosphate dehydrogenase (G6PD) deficiency are not fully established at the national level in Lebanon. Screening for the above disorders was carried out for newborns delivered at the American University of Beirut Medical Center over a period of five years. SUBJECTS AND METHODS: Blood specimens collected 2-3 days after birth were applied to neonatal screening blood collection cards. A total of 9117 newborns were screened using phenylalanine, thyroid-stimulating hormone, and G6PD activity measurements on blood spots. RESULTS: One case of phenylketonuria and another of hyperphenylalaninemia were detected. We also detected 5 cases of permanent type of congenital hypothyroidism, giving an incidence of 5:9117 (1:1823). The age range at initiation of hormonal replacement therapy was 9-46 days. The overall incidence of G6PD was 106:9117 (1:86 or 1.16%), of which 84 had complete deficiency (1:109 or 0.92%), and 22 with intermediate activity. CONCLUSION: The incidence of these disorders found in this Lebanese sub-population warrants consideration of a comprehensive nationwide neonatal screening program.

Journal Article↗
PubMedDate not supplied

Susceptibility of bacterial isolates to cefepime in comparison to other broad spectrum antimicrobial agents at a tertiary care center in Lebanon.

Newly introduced antimicrobial agents have to be evaluated to establish their current activity and susceptibility data base against microorganisms for future comparison. Cefepime is a fourth generation cephalosporin that was recently introduced in Lebanon but no background susceptibility data is available for it in this country. We prospectively analyzed the antimicrobial susceptibility pattern of the bacterial isolates from the American University of Beirut Medical Center to a number of broad spectrum antimicrobial agents and compared it to the susceptibility of cefepime. Consecutive clinical bacterial isolates, representing 665 gram-negative and 387 gram-positive were tested: 82 to 100% of the gram-negative isolates were susceptible to cefepime, including most of the extended spectrum beta-lactamase producing Enterobacteriaceae. All the oxacillin susceptible staphylococcus isolates, and the penicillin susceptible Streptococcus spp. as well as 92% of the S. pneumoniae isolates were susceptible. The data shows that currently, cefepime provides a very broad spectrum of activity against gram-positive as well as gram-negative bacterial isolates recovered from clinical specimens.

Cefepime↗
PubMed2002

Evidence for negative cross resistance to insecticides in field collected Spodoptera littoralis (Boisd.) from Lebanon in laboratory bioassays.

A sample of Spodoptera littoralis pupae were field collected from in Lebanon in November 1999. Approximately 50 healthy pupae were used to initiate a laboratory colony (stain code LEB). As a benchmark for sensitivity to insecticides the susceptible laboratory strain (LET) was used for comparison. The LET stain has been held in laboratory culture for over 10 years and originated from Israel. Three test chemicals were investigated; Spinosad (Tracer, 480 g/L SC), chlorpyrifos (Dursban 480 g/L EC) and cypermethrin (Ambush C 100 g/L EC) representing a range of different modes of actions. To estimate the sensitivity of the LEB strain relative to the LET stain laboratory bioassays, conducted on second instar larvae exposed treated tomato leaves for two days. The method used was based on IRAC (Insecticide Resistance Action Committee) insecticide susceptibly test number 7. Larvae from the LEB strain were tested in both the F1 and F2 laboratory generations. LC50 values were calculated using a Log-Probit model allowing the susceptibly of each strain to each test item to be compared. The LEB (field) strain were approximately twice as sensitive to spinosad compared with the LET (laboratory) strain. The LEB strain was 6-10 times less sensitive to chlorpyrifos which was within the range expected. However the LEB stain was 250-360 times less sensitive to cypermethrin compared with the LET strain, indicating a high level of resistance to pyrethroids in the field population. This kind of relationship gave a strong indication for negative cross resistance between spinosad and cypermethrin. It was concluded that spinosad had potential as a resistance management tool due to its novel mode of action and negative cross resistance with pyrethroids.

Animals↗