Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Objectives: Studies have correlated second hand smoke (SHS) with many diseases, especially respiratory effects. The goal of this study was to measure the impact of SHS on the respiratory symptoms and exhaled carbon monoxide. Material and Methods: The study population consisted of 50 young workers in restaurants serving waterpipes, 48 university students who sit frequently in the university cafeteria where cigarette smoking is allowed and 49 university students spending time in places where smoking is not allowed. Subjects completed questionnaires on socio-demographic characteristics, respiratory symptoms and exposure to SHS. Exhaled carbon monoxide levels were measured. ANOVA and Chi-square tests were used when applicable as well as linear and logistic regression analysis. Results: Exposure to cigarette smoke in university (adjusted odds ratio (ORa) = 6.06) and occupational exposure to waterpipe smoke (ORa = 7.08) were predictors of chronic cough. Being married (ORa = 6.40), living near a heavy traffic road (ORa = 9.49) or near a local power generator (ORa = 7.54) appeared responsible for chronic sputum production. Moreover, predictors of chronic allergies were: being male (ORa = 7.81), living near a local power generator (ORa = 5.52) and having a family history of chronic respiratory diseases (ORa = 17.01). Carbon monoxide levels were augmented by the number of weekly hours of occupational exposure to waterpipe smoke (β = 1.46) and the number of daily hours of exposure to cigarette smoke (β = 1.14). Conclusions: In summary, young non-smoker subjects demonstrated more chronic cough and elevated carbon monoxide levels when exposed to SHS while the effect of waterpipe was even more evident

Hypertension in the Lebanese adults: Impact on health related quality of life

Cardiovascular disease is a major cause of morbidity and mortality worldwide, hypertension being one of their most prevalent risk factors. Information on health related quality of life (QOL) of hypertensive individuals in Lebanon is lacking. Our objectives were to evaluate QOL of hypertensive patients compared with non-hypertensive subjects and to suggest possible predictors of QOL in Lebanon. We conducted a case control study among individuals visiting outpatient clinics. Quality of life was assessed using the eight item (SF-8) questionnaire administered face to face to the study population, applied to hypertensive (N = 224) and non-hypertensive control (N = 448) groups. Hypertensive patients presented lower QOL scores in all domains, particularly in case of high administration frequency and occurrence of drug related side effects. Among hypertensive patients, QOL was significantly decreased with the presence of comorbidities (β = −13.865, p = 0.054), daily frequency of antihypertensive medications (β = −8.196, p < 0.001), presence of drug side-effects (β = −19.262, p = 0.031), older age (β = −0.548, p < 0.001), female gender (β = −21.363, p = 0.05), lower education (β = −22.949, p = 0.006), and cigarettes smoked daily (β = −0.726, p < 0.001); regular sport activity (β = 23.15, p < 0.001) significantly increased quality of life. These findings indicate the necessity for health professionals to take these factors into account when treating hypertensive patients, and to tackle special subgroups with attention to their deteriorated QOL

Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon

Objectives: to assess the knowledge of both parents and community pharmacists regarding antibiotics use and resistance in pediatrics in Lebanon. Methods: A cross-sectional study was conducted between June and August 2017 in community pharmacies. A pre-established questionnaire targeting knowledge of parents and pharmacists regarding antibiotics use/misuse was carried out. An index of knowledge was computed to assess factors associated with good knowledge on antibiotics use/misuse. Results: The study showed that 28.7% of pharmacists did not know which factors may contribute to antimicrobial resistance. Concerning the misuse of antibiotics, pharmacists blamed at first parents (90.1%), at second level physicians (72.8%), and third themselves (59.4%). Furthermore, pharmacists believed that the socioeconomic problems of the country (86.1%), the level of resistance to the molecule of choice (80.8%), the lack of consultation time (71.2%) and the lack of national guidelines/recommendations (66.3%) might be additional factors contributing to antimicrobial resistance. In case of acute otitis media, the majority of pharmacists chose the correct treatment, dose and duration according to international guidelines; this was in contrast to the results obtained in case of pharyngitis. Female pharmacists had a significantly higher knowledge score compared to their male counterparts (ORa=2.51). Half of parents (42.6%) declared that antibiotics act against both viruses and bacteria, 55.9% still believe that the presence of fever requires the administration of antibiotics, 50% didn’t know the consequences of antibiotics misuse, 58.4% said that it is okay to give their child antibiotics without a physician's advice and/or based on a pharmacist’s recommendation, and 66.7% trusted the pharmacist in the antibiotic prescription. Parents with a university level of education or a master’s degree had significantly better knowledge compared to illiterate ones (ORa=9.04 and ORa=16.46, respectively). Conclusions: Based on the results obtained, it would be necessary to implement educational campaigns in order to increase awareness on antibiotics misuse and resistance in pediatrics

Adherence to the Mediterranean diet decreases the risk of stroke in the Lebanese population: a case-control study

Objective: The objective of this study was to assess adherence to the Mediterranean diet (MeD) and the risk of stroke in the Lebanese population. Methods: A hospital based case-control study was conducted in Lebanon between January 1st, 2015 and December 31st, 2016. Data were collected prospectively using a standardized questionnaire. Adherence to the MeD was assessed based on the total number of points a patient can have on the MeD scale. Data were analysed using SPSS version 24. The strength of association between the risk of stroke and adherence to MeD was expressed in odds ratio (OR) through 95% confidence interval. P-value <0.05 determined statistical significance. Results: Around 205 stroke cases and 445 hospitalized stroke-free patients were included in this study. In the total study sample, the MeD had a minimum of 2 and a maximum of 11 points with a median of 7 points. Stroke patients had a lower MeD median compared to controls (6 vs 8 points). Around 29.5% of the total sample had a MeD score within the first quartile (52.3% of them had a stroke) and 24% of all included subjects scored within the last quartile (7% of them hospitalized for stroke) (p<0.001). The higher the adherence to MeD the lower the risk of stroke. High adherence to MeD was associated with a decreased risk of stroke, OR 0.1 (95%CI, 0.04-0.24; p<0.001). Conclusions: Higher adherence to MeD significantly decreases the risk of stroke in the Lebanese population. Good lifestyle choices are encouraged in order to prevent many vascular diseases including stroke

Prevalence and Risk Factors of Low Back Pain among Office Workers in Lebanon

Low back pain (LBP) is a widespread musculoskeletal disorder worldwide. It causes disability that influence work performance in individuals. The aim of this study was to evaluate the prevalence and risk factors of LBP in the middle-aged office workers in the Lebanese Population. In this observational, cross-sectional study performed in 2013, overall, 250 office workers aged between 20 and 64 years from different Lebanese companies and banks filled out a questionnaire containing various predictor individual and occupational factors. Our results show that 112 (44.8%) of the recruited population suffer from back pain. Females are the most affected (68%) versus males (32%) (P=0.023). The logistic regression showed that LBP was positively associated with backbone crookedness (P=0.003), knee pain (P 5 hours (P=0.024), fear of changing job (P=0.036) and higher BMI (P=0.005). However, use of ergonomic chair, job advancement satisfaction, making radiography was negatively associated with LBP with P value=0.072, 0.022, 0.005 respectively. LBP has an important prevalence among office worker in Lebanon. This study might help to estimate low back problems in office workers and emphasize healthy lifestyle, ergonomic measurement and holding educational programs

Drug-related Problems Among Type 2 Diabetic Patients With Hypertension in a Tertiary Care Hospital in Lebanon: A Cross-sectional Study

Background: Patients with type 2 diabetes (T2D) often have other associated comorbidities, making them susceptible to drug-related problems (DRPs) which can adversely affect their quality of life. Understanding these problems can provide baseline data to allow informed health decisions and effective management of patients.  Objectives: This study aims to investigate DRPs in T2D patients with hypertension and find the predictors of these problems.  Methods: This cross-sectional study was conducted for six months in the internal medicine department of a tertiary care hospital in Lebanon. Participants were 135 adult T2D patients with hypertension who were receiving one or more anti-diabetes drugs, and at least one medication for hypertension. Pharmaceutical care network europe classification system was used to classify the DRPs. Data were collected by two clinical pharmacists using a self-report tool. Results: Most of patients were female. Most of them (94.1%) had at least one DRP (1.43±0.72 per patient). “Non-optimal drug treatment effect” was the most frequent problem (48.2%). Achieving the HbA1C target reduced the odds of this problem by 66.6%, while the increased serum creatinine level caused a two-fold increase in this problem. The use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers reduced the odds of DRPs by 86.2% and 83.3%, respectively, while lipid-lowering and anti-anginal drug use caused a four-fold increase in DRPs.  Conclusion: Early identification of DRPs in diabetic patients with hypertension and their associated factors can help improve their management and reduce the associated mortality and morbidity rates

Evaluation of risk factors and drug adherence in the occurrence of stroke in patients with atrial fibrillation

Background: Atrial fibrillation (AF) patients are at high risk of developing a stroke and anticoagulant medications are generally prescribed to prevent stroke in AF population. Objective: This study aims to evaluate stroke risk factors among hospitalized patients with AF and to assess the level of adherence to medications in AF patients and their relation with stroke. Methods: This is a case-control study conducted between June 1st, 2018 and December 31th, 2018 among AF patients admitted to seven tertiary Lebanese hospitals. Data were collected using a standardized questionnaire. Adherence to medications was assessed using the Lebanese Medication Adherence Scale-14. Odds ratios (OR) expressed the strength of association between the independent variables and the dependent variable and were estimated using unconditional logistic regression adjusted for confounding factors. P<0.05 determined statistical significance. Results: In total, 174 cases of AF patients were included with 87 cases and 87 controls. The risk of stroke among AF significantly increased with the presence of a history of hypertension, aOR 16.04 (95%CI, 2.27-113.37; p=0.005), history of coronary heart disease/myocardial infarction, and history of obesity. Anticoagulant medication significantly decreased the risk of stroke among AF patients, aOR 0.27 (95%CI, 0.07-0.98; P=0.047). High adherence to medications was significantly associated with a reduced risk of stroke, aOR 0.04 (95%CI, 0.01-0.23; p<0.001). Conclusions: Having a history of hypertension is one of the strongest risk factors for stroke among AF patients in Lebanon. While anticoagulant medication use was associated with a reduced risk for stroke, high adherence to medications is critical for stroke prevention. Public health interventions are needed to tackle low-adherence to medication and prevent stroke among AF patients

Barriers to Access Multiple Sclerosis Disease-Modifying Therapies in Middle East and North Africa: A Regional Survey-Based Study

International audienceMultiple sclerosis (MS) management varies markedly between different countries of the Middle East and North Africa (MENA) region based on disease-modifying therapies (DMTs) availability, accessibility, and reimbursement. In general, introduction of novel DMTs in most MENA countries is usually delayed, as drug approval can take several months to years once approved for use by the Food and Drug Administration (FDA) or European Medicines Agency (EMA), depending on the country. To our knowledge, there are no published studies assessing the accessibility to DMTs across different countries of the region

Energy Drink Consumption among Physically Active Persons in Lebanon: A Multicenter Cross-Sectional Study

Energy drinks (EDs) are caffeinated drinks marketed as energy and performance boosters and commonly used by athletes worldwide. They are widely used among youth and university students, with limited research about their consumption among physically active persons. Objectives: This study aims to assess ED consumption among physically active persons in Lebanon, the association between ED use and the participants’ general characteristics, and to explore the predictors of ED use among them. Methods: An observational cross-sectional study was conducted over three months, targeting 384 physically active persons from 8 gyms across Lebanon. Results: The prevalence of ED consumption was 49.2%, namely to boost energy (68.2%) and stimulate awakeness (19.3%). Around 20% used EDs during workouts, and 15.8% used them before it. Females had 59% lower odds of ED consumption than males (OR 0.41, 95% CI 0.19-0.89), while older participants had 4.74 times higher odds of ED use (OR 4.74, 95% CI 1.16-19.3). Waterpipe smokers and alcohol consumption had 3.68 and 2.28 times higher odds of ED use than non-users. Among other sports, those doing weightlifting had significantly higher odds of ED consumption than others (OR 2.61, 95% CI 1.30-5.25). Conclusion: The predictors of ED consumption should be considered for better-informed decisions and effective awareness campaigns

Facteurs associés à l'épilepsie : Etude cas-témoins dans la population Libanaise

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