Post-graduation migration intentions of students of Lebanese medical schools: a survey study

<p>Abstract</p> <p>Background</p> <p>The international migration of physicians is a global public health problem. Lebanon is a source country with the highest emigration factor in the Middle East and North Africa and the 7th highest in the World. Given that residency training abroad is a critical step in the migration of physicians, the objective of this study was to survey students of Lebanese medical schools about their intentions to train abroad and their post training plans.</p> <p>Methods</p> <p>Our target population consisted of all students of Lebanese medical schools in the pre-final and final years of medical school. We developed the survey questionnaire based on the results of a qualitative study assessing the intentions and motives for students of Lebanese medical schools to train abroad. The questionnaire inquired about student's demographic and educational characteristics, intention to train abroad, the chosen country of abroad training, and post-training intention of returning to Lebanon.</p> <p>Results</p> <p>Of 576 eligible students, 425 participated (73.8% response rate). 406 (95.5%) respondents intended to travel abroad either for specialty training (330 (77.6%)) or subspecialty training (76 (17.9%)). Intention to train abroad was associated with being single compared with being married. The top 4 destination countries were the US (301(74.1%)), France (49 (12.1%)), the United Kingdom (31 (7.6%)) and Canada (17 (4.2%)). One hundred and two (25.1%) respondents intended to return to Lebanon directly after finishing training abroad; 259 (63.8%) intended to return to Lebanon after working abroad temporarily for a varying number or years; 43 (10.6%) intended to never return to Lebanon. The intention to stay indefinitely abroad was associated male sex and having a 2^ndcitizenship. It was inversely associated with being a student of one of the French affiliated medical schools and a plan to train in a surgical specialty.</p> <p>Conclusion</p> <p>An alarming percentage of students of Lebanese medical schools intend to migrate for post graduate training, mainly to the US. A minority intends to return directly to Lebanon after finishing training abroad.</p

Conception et réalisation d'un séparateur acousto-optique de polarisation

Le travail présenté concerne la conception et la réalisation d'un séparateur acousto-optique de polarisation. Celui ci est basé sur une double interaction anisotrope dans la Paratellurite, matériau aux propriétés exceptionnelles.Deux modes de fonctionnement validés expérimentalement sont proposés : bifréquence pour une sélection indépendante de polarisation ou monofréquence pour une séparation simultanée des deux composantes de polarisation.Ce séparateur a ensuite utilisé dans deux applications : le contrôle du phénomène d'image fantômes en vidéoprojection laser stéréoscopique et l'analyse de la polarisation lumineuse à partir d'un protocole expérimental original.This work is devoted to the conception and the realisation of a polarisation acousto-optic separator. It is based on a double anisotropic interaction in Paratellurite, material with exceptionnal properties.Two operating modes have been experimentally validated : the bifrequency mode for a independant selection of the polarisation and the monofrequency mode for a simultaneous separation of the two polarised composants. The separator has been used two applications : control of the " ghost " phenomenon in a stereoscopic laser videoprojector and the analysis of the light polarisation using a specific experimental protocol.VALENCIENNES-BU Sciences Lettres (596062101) / SudocSudocFranceF

A Plasmid-Borne blaOXA-58 Gene Confers Imipenem Resistance to Acinetobacter baumannii Isolates from a Lebanese Hospital▿

We investigated the basis of the carbapenem resistance of 17 multidrug-resistant Acinetobacter baumannii clinical isolates collected from 2004 to 2005 at the Saint George University Hospital in Beirut, Lebanon. A. baumannii isolates were clonally related and were susceptible to colistin and trimethoprim-sulfamethoxazole, susceptible or intermediate to ampicillin-sulbactam and meropenem, and resistant to all other antimicrobials. Conjugation experiments demonstrated that resistance to imipenem could be transferred along with a plasmid containing the carbapenem-hydrolyzing oxacillinase blaOXA-58 gene. The plasmid that we called pABIR was 29,823 bp in size and showed a novel mosaic structure composed of two origins of replication, four insertion sequence (IS) elements, and 28 open reading frames. The blaOXA-58 gene was flanked by IS18 and ISAba3 elements at the 5′ and 3′ ends, respectively. The production of the carbapenem-hydrolyzing oxacillinase OXA-58 was apparently the only mechanism for carbapenem resistance in A. baumannii isolates causing the outbreak at the Lebanese Hospital

Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients. Univariate analysis showed that prior exposure to high dose steroids, diabetes mellitus, mechanical ventilation, prior use of colistin and tigecycline, presence of septic shock, and critical care unit stay were associated with a poor outcome. High dose steroids and presence of septic shock were significant on multivariate analysis. Crude mortality rate was 63.5%. 70.3% of the deaths were attributed to the bacteremia. On acquisition, 39 patients had septicemia. Despite high index of suspicion and initiation of colistin and/or tigecycline in 18/39 patients, a grim outcome could not be averted and 37 patients died within 2.16 days. Seven patients had transient benign bacteremia; three of which were treated with removal of the line. The remaining four did not receive any antibiotics due to withdrawal of care and died within 26.25 days of acquiring the bacteremia, with no signs of persistent infection on follow up. A prolonged hospital stay is frequently associated with loss of functionality, and steroid and antibiotic exposure. These factors seem to impact the mortality of AB bacteremia, a disease with high mortality rate and limited therapeutic options

Shingles and Pericarditis: A Rare Combination

Clinical infection with varicella in both its ’ forms, primary and reactivation, can be associated with a variety of complications. Cardiac complications, though very rare, have been associated with the primary form of varicella zoster and as such should be recognized in order to initiate early treat-ment and prevent morbidity and mortality. However, cardiac complications have not been de-scribed in association with the reactivation form of varicella. We report a case of an adult immu-nocompetent male who presented with herpes zoster complicated by pericarditis with pericardial effusion and a positive varicella zoster virus (VZV) polymerase chain reaction (PCR) in pericardial fluid

Control and Elimination of Extensively Drug-Resistant Acinetobacter baumanii in an Intensive Care Unit

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