Knowledge, attitude and practice of Lebanese community pharmacists with regard to self-management of low back pain

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain.Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice.Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists.Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice. Keywords: Attitude, Knowledge, Low back pain, Reported practice, Quality of advic

Clinicopathologic Correlation of Pigmented Epiretinal Membranes

We performed clinicopathologic correlation on ten surgically removed pigmented epiretinal membranes causing macular pucker. All cases occurred in eyes with existing retinal holes or tears, including eight cases of macular pucker after previous retinal detachment. These cases probably represented a limited form of proliferative vitreoretinopathy. All membranes contained pigment epithelial cells with polarity, basement membrane, and melanosomes. Cytoplasmic melanin granules accounted for the clinical feature of pigmentation in these eyes

Acute Corneal Hydrops Mimicking Infectious Keratitis as Initial Presentation of Keratoconus in a 10-Year-Old Child

Purpose. To report a case of acute hydrops in a 10-year-old child with advanced keratoconus. Case Presentation. A ten-year-old boy diagnosed as having right eye (RE) infectious keratitis, not responding to antimicrobial therapy, was referred to our hospital. The diagnosis of infectious keratitis was established one month prior to his presentation following an episode of acute corneal whitening, pain, and drop in visual acuity. Topical fortified antibiotics followed by topical antiviral therapy were used with no improvement. Slit lamp examination showed significant corneal protrusion with edema surrounding a rupture in Descemet’s membrane in the RE. The diagnosis of acute corneal hydrops from advanced keratoconus was highly suspected and confirmed with corneal topography. Conclusion. Although a relatively rare disease at the age of 10 years, keratoconus can be rapidly progressive in the pediatric group. Keratoconus should always be considered in the differential diagnosis of progressive vision loss in this age group

Pars plana vitrectomy for disturbing primary vitreous floaters: clinical outcome and patient satisfaction

Item does not contain fulltextBACKGROUND: Primary vitreous floaters can be highly bothersome in some patients. In the case of persistently bothersome floaters, pars plana vitrectomy may be the most effective treatment. The aim of this study is to evaluate the incidence of complications, and patient satisfaction, after pars plana vitrectomy for disabling primary vitreous opacities. METHODS: We included a total of 110 eyes that underwent pars plana vitrectomy between February 1998 and August 2010. Fifty-seven eyes (51.8%) underwent 20-gauge vitrectomy, whereas 53 eyes (48.2%) underwent 23-gauge vitrectomy. In a retrospective manner, we assessed intraoperative and postoperative complications. There was a considerable range of time between surgery and questionnaire (range: 4-136 months). Patient satisfaction was assessed by a questionnaire based on a modified NEI VFQ-25 questionnaire. RESULTS: A retinal detachment occurred in 10.9% of cases, and the incidence did not differ significantly between the 20-gauge and 23-gauge vitrectomy groups. In 4.5% of the eyes, a retinal detachment developed within the first 3 months, and 6.4% occurred later in the postoperative period. Cystoid macular edema occurred in 5.5%, and an epiretinal membrane was seen postoperatively in 3.6% of cases. Development of glaucoma requiring glaucoma surgery, a macular hole, and postoperative scotoma, each occurred in 0.9% of cases. No cases of endophthalmitis occurred. Eighty-five percent of patients were satisfied or very satisfied with the results of the vitrectomy. Eighty-four percent of all patients were completely cured from their troublesome vitreous floaters, and an additional 9.3% of patients were less troubled by vitreous floaters. Ten patients (9.3%) were dissatisfied, and six of these patients (5.6%) had a serious complication that resulted in permanent visual loss. CONCLUSIONS: Pars plana vitrectomy is an effective approach to treat primary vitreous floaters, resulting in a high rate of patient satisfaction. Postoperative complications may be more frequent than previously reported, so patients should be well-informed about the complication rate before reaching informed consent about this surgical intervention. Additional preventive measures should be considered to reduce this complication rate