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PubMed2005

Behçet's disease in Lebanon: clinical profile, severity and two-decade comparison.

The aim of this study is to describe the clinical features of Lebanese patients with Behçet's disease (BD) followed up at a tertiary care center in Lebanon. A retrospective review of medical records of 90 patients who fulfilled the International Study Group (ISG) criteria for diagnosis was performed. The clinical characteristics and severity score were compared with those reported from other populations of Arab and of Turkish origin using the same diagnostic criteria, and a comparison over two decades for the Lebanese population was made. The male-to-female ratio was 2.9:1, the mean age at onset, 25.4 years, and mean age at diagnosis, 29.2 years. One hundred percent of the patients had mouth ulceration; 72.2%, genital ulceration; 59.1%, arthritis; 55.7%, papulopustular skin lesion; 53.9%, ocular disease; 36.8%, vascular disease; 29.5%, erythema nodosum; and 23.0%, neurologic disease. The characteristics of our patient population are similar to that reported from other countries in the region. However, we found a higher prevalence of vascular and neurologic disease.

Adolescent↗

PubMed2005

Seasonal variations of trace metal chemical forms in bed sediments of a karstic river in Lebanon: implications for self-purification.

Although Lebanon has abundant water, its rivers are polluted and aquifer water mismanaged. Effective river water usage requires an understanding of the geochemistry of polluting metals in catchments. Climate is "Mediterranean": wet winters and dry summers. Active sediment flushing is restricted to winter high discharge episodes. Except in winter, water column pollutants are removed by precipitation or sorption to the surface of static bed sediments. Hence (1) does winter flushing of contaminated sediment and replacement by clean sediment favour self purification? (2) does the distribution of metals between extractable fractions change seasonally and thereby affect metal bioavailability ? Results on the distribution of metals are reported for Fe, Pb, Zn, Cu and Cd in bed sediments from Nahr Ibrahim (a karstic river) for summer and winter. A Tessier-like sequential extraction scheme was applied to samples (< 75 microm) for five locations along a 13 km stretch to the sea. Water pH was above 8.2 at all locations implying a very low solubility for Fe. Sediment was derived from catchment soils and limestone. Total sediment Fe increased in winter at all sites following deposition of eroded soil from upstream. Cadmium, Cu and Pb derived from polluting sources; the sources of Zn were more complex. Dilution by clean sediment explained winter reductions in total Cd, Cu and Pb; Zn changes were less consistent. Iron occurred mostly (> 77 sum of fractions) in the residual fraction compared with 6- 31 for pollutants; residual Cu and Zn showed a small increase in winter whereas Cd and Pb did not change. All readily exchangeable metals decreased in winter and the carbonate bound forms predominated in both seasons. Nahr Ibrahim has a high capacity for self purification and metal resolubilization from sediment will be limited by the solubility of carbonate forms.

Chemical Fractionation↗

PubMed2006

Chronic bronchitis and pesticide exposure: a case-control study in Lebanon.

OBJECTIVE: Pesticides are widely used toxics. The objective of the study is to evaluate the odds of exposure to pesticides in chronic bronchitis patients. METHODS: Using the American Thoracic Society standardized questionnaire confirmed by medical diagnosis of chronic bronchitis, a case-control study was performed in Lebanon. Pesticide exposure was estimated and between groups comparison was made. RESULTS: The study involved 262 controls and 110 chronic bronchitis outpatient subjects from 10 medical centers. Any exposure to pesticides was associated to chronic bronchitis (OR = 2.46 [1.53-3.94]; p < 10(-4)). Occupational use presented the highest association (15.92 [3.50-72.41]; p < 10(-4)), followed by regional exposure (3.70 [2.05-6.70]; p < 10(-4)). Results were confirmed by multivariate and subgroup analysis. CONCLUSION: Pesticide exposure was associated with chronic bronchitis in Lebanese adults. Pesticides toxicological effects may explain chronic respiratory effects associations found with all exposure types.

Adult↗

PubMed2006

Variation of metals in bed sediments of Qaraaoun Reservoir, Lebanon.

The Qaraaoun Reservoir (impoundment of the River Litani) is the only artificial surface water body in the country, Lebanon. Earlier study on the water quality of the Qaraaoun Reservoir identified three water quality zoning with a central distinct zone suitable for multipurpose water usage. The objective of this study was to extend the earlier work by considering the total metal content of reservoir bed sediments and hence to evaluate factors that control metal deposition or capture. Water samples were collected from 15 sampling sites and sediment samples were simultaneously collected from 9 sites. Water parameters analyzed were pH, Eh, DO and temperature. Sediment samples were dried and sieved and sediment < 75 microm was retained for analysis. Sediments were subjected to a stepwise heating process with aqua regia to extract the metals, and their content in sediments determined by ICP-MS. The sediment data revealed higher metal contents where the river entered the reservoir which matched higher concentrations of water parameters at the influx site. Regression analysis of total metals in sediments with distance from the river Litani influx point to the dam revealed a log trend for Fe, Cr and Ni, whereas, the concentrations of Cu, Zn, Cd, Pb were better described by a polynomial regression. Three sediment zones were identified: entrance, oxidation (central) and reducing (near dam) zones. Sediment contents of Zn, Cu and Pb correlated with organic content, whereas sediment Cr and Ni were associated with iron. It was concluded that sediments act as a sink for metals and the deposition of metals is primarily related to sediment organic content and the level of dissolved oxygen in water.

Environmental Monitoring↗

PubMed2005

Preventive healthcare of infants in a region of Lebanon: parental beliefs, attitudes and behaviors.

OBJECTIVES: This study aimed to investigate healthcare seeking behaviors of mothers for themselves and their infants in the Bekaa Valley, Lebanon, to identify attitudes and beliefs towards the preventive healthcare of infants and to assess whether a healthcare-based intervention program would be accepted by the population. METHODS: Ninety-two interviews were conducted with women who had delivered a live birth in two hospitals in the Bekaa. The hospitals selected attracted women from different socioeconomic classes. RESULTS: Differences were found in adequacy of healthcare utilization based on household size, number of children and prenatal care utilization. There was a higher perception of barriers to healthcare by parents who did not seek adequate preventive care for their infants. Mothers of infants who had inadequate care had a lower perception of severity of illness and of physicians' ability to prevent illness. The population believes strongly that medical professionals are reliable sources of health information and guidance. Infants' mothers and grandmothers are important sources of healthcare-related information. CONCLUSIONS: Rates of preventive infant healthcare in the Bekaa need improvement. Any intervention must target mothers and grandmothers, as they appear to influence the medical care of infants. Other targets include parents of larger families. Dissemination of information regarding the seriousness of illness and the ability to prevent illness is required. The medical profession may influence health choices made by this population. However, further investigation of healthcare barriers, especially economic and geographic barriers, is needed. In preparing to improve healthcare utilization for infants in the Bekaa, local, regional and international organizations should refer to the population's beliefs, attitudes and behaviors described in this study, as these findings may aid in planning interventions that are likely to positively impact mothers and infants.

Adolescent↗

PubMed2006

Anilocra pilchardi n. sp., a new parasitic cymothoid isopod from off Lebanon (Eastern Mediterranean).

Anilocra pilchardi n. sp. is described from several specimens collected mainly from clupeiform fishes from off Lebanon. Various stages of the parasite are considered: ovigerous and non-ovigerous females, male and intramarsupial larvae. Taxonomic comments on the relationship of A. pilchardi to other congeneric species are given. A. pilchardi belongs to a particular group of Anilocra species previously known only from the Indo-Pacific Region.

Animals↗

PubMedDate not supplied

An outbreak of trichinosis in Lebanon.

In 1982 an outbreak of trichinosis occurred in an area of south Lebanon consisting of 4 villages, including 6440 persons. In 267 households, involving 2456 persons, typical clinical signs of Trichinella spiralis infection could be recognized among household members. Twenty-one of these households, including 193 persons, were randomly chosen for further studies. Nearly half of the household members (46%) had clinical symptoms consistent with acute trichinosis. 12 of 16 tested persons had high anti-Trichinella antibody titres (12 positive by indirect immunofluorescence (IIF) and 11 by enzyme-linked immunosorbent assay). Class-specific antibodies, IIF-immunoglobulin (Ig) G, IgM and IgA, were detected in most tested cases. Of the remaining 4 seronegative cases, 3 had a duration of clinical symptoms < or = 12 d. High peripheral eosinophilic counts (> 20%) were noted in 8 of 16 cases. In total, 15 of 16 cases were positive by one or more of these tests. The outbreak constituted one of the most extensive single outbreaks reported with a calculated > 1000 clinical cases. The cause was attributed to consumption of raw pork meat, an ingredient of kebbeh nayyeh, a favourite Lebanese dish.

Adolescent↗

PubMed1992

Field evaluation of a hepatitis A vaccine in a Norwegian contingent to the United Nations Interim Force in Lebanon.

The Norwegian population is basically seronegative regarding anti-hepatitis A antibodies. For this reason they are particularly vulnerable when exposed to hepatitis A virus when staying in highly endemic areas. Norwegian UN-personnel have so far been protected with serum immunoglobulins (Ig). Two studies are reported, one followed a vaccination schedule of 0, 1 and 2 months with a booster at month 12, while the other followed a schedule of day 0 and 14 with a booster at month 7. Both were field trials evaluating the new hepatitis A vaccine, from SmithKline Beecham Biological, in Norwegian UN soldiers serving in Lebanon. Both trials showed 100% seroconversion following the initial vaccination course, with low reactogenicity and no clinical or subclinical sign of hepatitis. The new vaccine has decisive advantages over immunoglobulins on medical, practical and economic grounds.

Adult↗

PubMed1989

Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon.

A sample of 152 women living in Beirut, Lebanon was studied to determine the relationship between life experiences, mothers' depression, and children's health and behavior. Measures of the perceived negative impact of both war and nonwar related events, measures of available social support, sociodemographic variables, coping or response strategies and displacement were used to predict mothers' depressive symptomatology and their children's health. The level of perceived negative impact of war-related events was found to be strongly associated with higher levels of depressive symptomatology among mothers. More surprising was the relative importance of experiences unrelated to the war in predicting higher levels of depressive symptoms. Among the most noteworthy of the findings was the association between the use of an emotional response style and the measure of psychological dysfunction. Finally, the level of a mother's depressive symptomatology was found to be the best predictor of her child's reported morbidity, with higher levels of symptoms associated with higher levels of morbidity.

Child↗

PubMed2004

Is seroprevalence of HTLV-I/II among blood donors in Lebanon relevant?

Human T-cell lymphotropic virus type I (HTLV-I) is associated with certain hematologic and neurologic disorders. Seroprevalence studies demonstrated that the distribution of HTLV-I is heterogeneous worldwide and not specific to 1 region. Because blood is one of the major routes of transmission of the virus, blood banks of several countries routinely screen all blood donations for HTLV-I. The aim of the present study was to assess the seroprevalence rate of HTLV-I/II antibodies among Lebanese blood donors. Between August 2001 and March 2002, consecutive blood samples of 3529 blood donors were collected at blood banks of 4 major hospitals in Lebanon. Initial enzyme-linked immunosorbent assay (ELISA) screening resulted in 23 (0.7%) positive samples, of which 12 (0.3%) were reconfirmed positive by ELISA. Further analysis by Western blot resulted in 2 (0.06%) positive samples, of which 1 tested positive for HTLV-I by PCR (0.028%). Although its very low prevalence among Lebanese blood donors does not support routine screening of Lebanese blood donors for HTLV-I, screening of blood donors from other nationalities may be exercised, especially those from HTLV-I endemic areas.

Adult↗

PubMed2004

Chemical composition of the essential oil of Salvia multicaulis Vahl. var. simplicifolia Boiss. growing wild in Lebanon.

The essential oil of aerial parts of Salvia multicaulis Vahl. var. simplicifolia Boiss. (Lamiaceae) growing wild in Lebanon was obtained by hydrodistillation and was analysed by GC and GC-MS. 67 compounds constituting 95.2% of the oil were identified, the major components being alpha-copaene (8.0%), alpha-pinene (6.6%), myrtenol (5.7%), trans-sabinyl acetate (5.3%).

Gas Chromatography-Mass Spectrometry↗

PubMed2006

Chemical composition of the essential oil of Salvia microstegia Boiss. et Balansa growing wild in Lebanon.

The essential oil of aerial parts of Salviamicrostegia Boiss. et Balansa (Lamiaceae) growing wild in Lebanon was obtained by hydrodistillation and was analysed by GC and GC-MS. 70 compounds, representing 94.0% of the oil, were identified. The major components were caryophyllene oxide (6.2%), pulegone (5.7%), 4-vinylguaiacole (5.3%), hexadecanoic acid (5.1%) and menthone (4.9%).

Chromatography, Gas↗

PubMed2006

Penicillin-resistant Streptococcus pneumoniae in Lebanon: the first nationwide study.

A total of 123 clinical isolates of Streptococcus pneumoniae were collected from all over Lebanon and tested for their susceptibility to penicillin: 30.1% were susceptible (minimum inhibitory concentration (MIC) < or = 0.06 microg/mL), 56.1% were intermediately susceptible (MIC 0.09-1.0 microg/mL) and 13.8% were resistant (MIC > 1.0 microg/mL). The oxacillin disk screening test detected all penicillin-resistant isolates, but erroneously designated two penicillin-intermediate isolates as penicillin susceptible. All isolates were consistently susceptible to levofloxacin, but cross-resistance between penicillin and the three tested cephalosporins was frequently noted. The in vitro activity of amoxicillin/clavulanic acid paralleled that of penicillin; however, 92.7% of the isolates were designated as susceptible based on the recommended interpretive cut-off point (MIC < or = 2/1 microg/mL). This discrepancy represents a paradox that deserves serious consideration.

Lebanon↗

PubMed2004

Screening of selected indigenous plants of Lebanon for antimicrobial activity.

The objective of this study is to test in vitro the antimicrobial efficacy of 39 water and 39 methanol extracts derived from different parts of 27 indigenous wild plant species that have been commonly used in Lebanese folk medicine. The antimicrobial efficacy was determined using the single disk diffusion method, with 10 and 20 microl load extract volume per disc. Nine test microorganisms were used namely, Escherichia coli, Proteus sp., Pseudomonas aeruginosa, Shigella dysenteria, Salmonella enteritidis, Salmonella typhi, Staphylococcus aureus, Streptococcus faecalis, and Candida albicans. Only one water extract out of 39 derived from whole plant of Alchemilla diademata showed an antimicrobial activity against Staphylococcus aureus. The percentage of test organisms that were susceptible to 10 most efficacious methanol plant extracts (20 microl/disc) were as follows: Achillea damascena whole plant (88.8%), Anthemis scariosa flower (88.8%), Cirsium sp. whole plant (88.8%), Centaurea ainetensis flowers (88.8%), Hieracium sp. whole plant (88.8%), Origanum libanoticum whole plant (99.9%), Ranunculus myosuroudes whole plant (88.8%), Nepata curviflora leaf (88.8%), Nepata curviflora stem, and Verbascum leptostychum flower (99.9%). The minimum inhibitory concentration (MIC) was determined on plant extracts that showed high efficacy against the test organisms. The chance to find antimicrobial activities was more apparent in methanol rather than water extracts of the same indigenous plants of Lebanon, with higher antimicrobial activities in 20 microl methanol extract-discs in comparison to that present in the 10 microl discs (P < 0.05).

Anti-Infective Agents↗

PubMed2004

[A 4-year study of Pseudomonas aeruginosa susceptibility to antibiotics (1998-2001) in northern Lebanon].

Four hundred and sixty-four Pseudomonas aeruginosa strains were isolated in northern Lebanon at the Islami Hospital Microbiology department, in Tripoli. The purpose of this study was to evaluate the susceptibility of these strains to antibiotics, to compare this susceptibility according to the nature of the sample and the year of sampling. The results show that urinary samples were the most frequent (39.3%), followed by wound samples (21.2%), and ear samples (16.5%). The average rate of susceptible strains was 39.8% to ticarcillin, 56.9% to piperacillin, 58.2% to piperacillin + tazobactam, 74.1% to imipenem, 63.3% to ceftazidime, 60.4% to cefepime, 62.1% to aztreonam, 60.3% to netilmicin, 57.5% to gentamicin, 62.2% to tobramycin, 69% to amikacin, 100% to colistin, 45.4% to pefloxacin and ofloxacin, 57.7% to ciprofloxacin and 1.3% to rifampicin. The study showed that the strains isolated from pulmonary secretions were the most resistant to antibiotics.

Anti-Bacterial Agents↗

PubMed2004

Towards a topographical model of narghile water-pipe café smoking: a pilot study in a high socioeconomic status neighborhood of Beirut, Lebanon.

A pilot study of narghile water-pipe smokers in a cafe in the Hamra neighborhood of Beirut, Lebanon, was conducted to develop a preliminary model of narghile water-pipe smoking behavior for use in laboratory smoking machine studies. The model is based on data gathered from smoking sessions of 30 min or longer duration from 52 smoker volunteers using a differential pressure puff topography instrument, as well as anonymous visual observations of 56 smokers in the same cafe. Results showed that the "average" water-pipe cafe smoking session consists of one hundred seventy-one 530-ml puffs of 2.6-s duration at a frequency of 2.8 puffs/min. The implications of this comparatively high-intensity puffing regimen on the production of toxic smoke constituents are discussed.

Adult↗

PubMed2005

Factors influencing development of management strategies for the Abou Ali River in Lebanon II: seasonal and annual variation.

The water quality of a river at any point reflects several major influences including but are not limited to climatic conditions and anthropogenic inputs. Assessing these influences is essential for managing land and water resources within a particular river catchment. The objectives of this study were to identify the causes of increasing or decreasing trends in the concentrations of various water quality parameters in the Abou Ali River in North Lebanon and to account for the consequential variations both annual and seasonal (low/high flow). The assessment was conducted at the end of the dry season in October 2002 and 2003 and the end of the wet season in March 2003 and 2004. Results established that dissolved oxygen levels were consistently higher at the end of the wet season. The concentrations of biochemical oxygen demand, ammonia nitrogen and ortho-phosphates did not exhibit a clear seasonal or annual variation. While the levels of total dissolved solids and nitrate nitrogen exhibited a decreasing trend in urban catchments, an increasing trend was observed in rural, agricultural and forested areas. The findings of this study reinforce the notion that management of point and non-point sources should be integrated as the combination of both sources connected with land use results in deleterious effects on water quality. The lack of good quality water hinders economic development and the potential for long term sustainability.

Ammonia↗

PubMed2006

Dietary exposure of children and teenagers to benzoates, sulphites, butylhydroxyanisol (BHA) and butylhydroxytoluen (BHT) in Beirut (Lebanon).

The acceptable daily intake (ADI) for a considered chemical is by definition the amount of that substance which can be ingested every day during the life time without appreciable health risk. The theoretical risk of exceeding the ADI for benzoates, sulphites, butylhydroxyanisol (BHA) and butylhydroxytoluen (BHT) has often been examined on the basis of worst case scenario. The aim of this paper is to assess the actual intake of the food additives listed above for a group of the Lebanese population (students aged between 9 and 18 years old) likely to be highly exposed to food additives through the consumption of processed foods. Dietary exposure was obtained by combining food consumption data with food additives levels determined by chemical analysis. Food products available in Lebanon and containing added benzoates, sulphites, BHA and BHT were identified. Overall 420 samples of foods and beverages were analysed. The determination of food additives residue levels was carried out according to the official methods adopted in "Lebanese Institute for agronomic research" (IRAL) on food as consumed. The acceptable daily intake (ADI) could be exceeded for sulphites and BHT by a fraction of the population, in particular within children of 9-13 years old. Among all food additive-containing foods, the highest contributors were: soft drinks to benzoates intake, nuts and canned juices to sulphites intake, bread and biscuits to BHA intake and chewing gum to BHT intake.

Adolescent↗