IS DAYCARE A SAFE PLACE FOR KIDS DURING COVID-19 PANDEMIC? OPINION OF THE LEBANESE MIDDLE TO LOW ECONOMIC STATUS MOTHERS

Purpose: COVID-19 pandemic has negatively impacted the whole society including mothers who struggled between paid work, housework, and full-time childcare. Daycare used to relieve part of this burden. Accordingly, the current study aimed to assess the mothers’ acceptability of sending their children to daycare and the factors that influenced the decision. Subject and Method: A cross-sectional questionnaire-based study was carried out through phone calls in November 2020. Lebanese mothers of children from 0 to 3 years were invited to participate in the study. The questionnaire included demographic data, perception of the ways of COVID-19 transmission, Snyder’s Hope Scale, and acceptability of mothers to send their children to daycare. Data was analysed using SPSS-version 20. Results were considered significant at p-value ≤0.05 with a confidence interval of 95%. Results: Results showed a good knowledge of the way of transmission of SARS-CoV-2. Nevertheless, food and drinks as well as pets were retrieved as a source of transmission in 66.2 and 3.1%, respectively. Mothers average hope reflects their neutrality in agreeing in quarantining and even their disagreement. Accordingly, 62% of the mothers agreed on sending their kids to daycare to overcome their confronted barriers; mainly to go to work. Conclusion: All the results reflect the high burden of raising children without institutional support as well as financial one which the mothers are exposed to during the COVID-19 pandemic. Consequently, daycare must reopen their doors, with special precautions, to relieve the burden on mothers. Moreover, the government must support daycare institutions economically to be affordable to a larger sample of low to middle-income families

VACCINATION FOR NEWLY EMERGED INFECTIOUS DISEASES AS A BLESSING OR CURSE FROM THE PERSPECTIVE OF THE LEBANESE POPULATION: A TWO-PHASE STUDY

Although vaccination campaigns have been vital in mitigating the spread of many pandemics, false information about COVID-19 vaccine through social media might have a negative impact on its acceptance. In Lebanon, prior to the vaccination campaign, the acceptance rate of COVID-19 vaccination did not exceed 20 %. In the current study, the acceptance of vaccination by Lebanese participants was studied following the launching of the vaccine. The aim of the work is to reveal the actual intention of the studied sample once the vaccine is available and investigate the change in the perception and acceptance rate of Lebanese citizens about vaccination as influenced by many factors over time. A cross-sectional questionnaire-based study was conducted in two separate phases (March 2021 and May 2021). In the first phase, the questionnaire included socio-demographic data and reasons for vaccine’s refusal. In the second phase, 2 sections were added, addressing the change in the attitude of participants towards vaccination, and the reasons behind this change. Data were analyzed using SPSS-version 20 and the results were considered statistically significant with p values ≤0.05. In both phases, the willingness to take the vaccine did not significantly change (p\u3e0.05). Although 80 % of participants consider vaccination important, only 50 % of the studied sample were willing to take the vaccine. Such findings confirm hesitancy that can be attributed to worries about long-term effects and incomplete information about the safety and efficacy of the vaccine. Therefore, awareness campaigns about false beliefs should be extensively conducted, with more emphasis on tailored education for special subpopulations, and other measures should be implemented more efficiently (e.g. restricted access to public places for unvaccinated individuals) to accelerate the vaccination rate

HAND SANITIZERS USE DURING COVID-19 PANDEMIC: KNOWLEDGE, PREFERENCE, AND ADHERENCE OF A SAMPLE OF THE LEBANESE POPULATION.

Purpose: Preventive measure has been a gold stone in reducing the spread of Coronavirus disease of 2019. These measures include quarantine, social distancing, face mask use, and most importantly hand hygiene. Consequently, alcohol-based hand sanitizers have been used abundantly. The current study aimed to assess the knowledge, preference, and practice toward hand sanitizers of the Lebanese community, during the pandemic period. Method: A cross-sectional questionnaire-based study was carried out from mid of May to mid of June 2020. Adult Lebanese residents from the 5 main Lebanese districts were invited to participate in the study. The questionnaire included demographic data, 5 knowledge questions, practice during COVID-19, and preferred characteristics of hand sanitizers. Data was analysed using SPSS-version 20. Results were considered significant at p-value ≤0.05 with a confidence interval of 95%. Results: Out of the 481 participants, 278 were unable to be quarantined, and accordingly 74.5% had to use hand sanitizers regularly. Gel form, fast-drying, and low price were the main factors behind the choice of hand sanitizers by percentages of 51.2%,40.2%, and 36.2%, respectively. Nevertheless, all types of hand sanitizers have caused skin irritation in 43% of the respondents. The knowledge score revealed an average score of 2.56±1.1 over 5 with a significantly higher means for medical workers and university degrees. Conclusion: Consequently, educational campaigns should target common people for the proper choice and use of hand sanitizers

ASSESSMENT OF COMMUNITY PHARMACISTS’ INVOLVEMENT IN PUBLIC HEALTH PROMOTION SERVICES IN BEIRUT, LEBANON

Background: The role of pharmacists is growing globally; the shift from the traditional role of preparing and dispensing medications, to a role in medication therapy management and public health services is started to be acceptable worldwide. Objective: The aim of the study was to assess the participation level of community pharmacists’ in certain public health services promotion as well as the barriers that hindered such provision. Method: A questionnaire based study has been carried targeting Lebanese community pharmacists working in Beirut, Lebanon. Socio-demographic information, types of public health consultations offered in the pharmacy, and the barriers confronted by the community pharmacists were collected and analyzed using SPSS version 24. Results: The level of involvement of community pharmacists in the provision of public health services accounted for 72.6, 72.2, 65, 46.2, 46.2, and 45.3% in counseling on hypertension, weight management, diabetes, contraceptive use, smoking cessation, and drug abuse, respectively. The Level of education, as well as years of experience, affected the pharmacist’s involvement in most of the services. Sixty-one percent from the participants offer drug treatment options to help their patients in smoking cessation. Nutrition and diet showed the highest ranked in terms of percentage (82.9%) in weight management. Eighty-three percent of the respondents counseled their patients when to start their combined hormonal contraceptives pills. Fifty-eight percent from the respondents offer psychological support when counseling on drug abuse. The highest percentage is seen when counseling regarding lifestyle modifications in both diabetes and hypertension management. Lack of time was one of the most common barriers to practice health promotion encountered by pharmacists. Conclusion: Even though the community pharmacists are playing a vital role in public health promotion, this role should be strengthen by implementing rules that impose this service and the necessary skills needed to achieve better outcomes

KNOWLEDGE AND ATTITUDE TOWARD COMMON COLD IN BEIRUT, LEBANON

Background Common cold is a self- limiting condition targeting the upper respiratory tract. Even though it resolves on its own yet it accounts for 40% of absentees from work and a large number of visits to the physician clinic. The most common sign and symptoms include sore throat, coryza, runny nose or congestion, muscle pain, and sometimes cough. Symptomatic treatment of this minor ailment can be either by herbal products or over the counter drugs. Nevertheless, it is always mistaken for Influenza or bacterial infection. The proper knowledge of this condition could prevent mistreatment and would keep the country’s resources intact. Accordingly, the aim of the current study is to assess the knowledge and attitude of a sample of the Lebanese population on the common cold. Method A cross-sectional descriptive questionnaire-based study was performed in Beirut area. The questionnaire was divided into three parts that included demographic information, as well as knowledge and attitude questions. Results were considered significant when P-value was ≤ 0.05 with a confidence interval of 95%. Results Three hundred eighty-five adult Lebanese participants were enrolled in the study. The youngest age group was more knowledgeable on common cold than the elderly. Moreover, Ph.D. holders scored the highest on the knowledge score (6.71/10). Alarmingly, 14.8% of the tested sample still use antibiotics as soon as their cold symptoms start. Around 88% of the participants believed that the Ministry of Public Health should be involved to ensure the understanding of this condition in Lebanon. Conclusion The role of all health care providers as well as their orders and the Ministry of Public Health is to ensure proper education on the common cold by conducting awareness campaigns

KNOWLEDGE, ATTITUDE, AND EXPERIENCE OF LEBANESE FEMALES TOWARD ORAL CONTRACEPTIVE USE

Family planning is a key to slow unsustainable population growth and the resulting negative impacts on the national development efforts. Birth control pills or oral contraceptives are commonly used among childbearing-age women for family planning. Accordingly, this study aimed to evaluate the knowledge, attitude, and experience of oral contraceptive use among Lebanese women. A descriptive, cross-sectional, questionnaire-based study was conducted in Beirut and suburbs in 2018. The questionnaire included sociodemographic information consisting of age, educational level, occupation, marital status, and past medical history. It also included four different sections describing the pattern of use of oral contraceptives, attitude, knowledge, and previous experience. Out of the 385 addressed, 367 participants completed the survey the age range from 20 to 44 years accounted for 77.11%. The most commonly used methods of contraception were withdrawal method (45%) and male condoms (20.7%) while the use of oral contraceptive pills accounted for 18.45%. The chief prescriber for pills was the physician (76.6%), whereas only 10% gave a role to the pharmacist. Side effects of oral contraceptives were a crucial cause that led two-thirds of pill users to stop them and use an alternative contraceptive method. Although the majority of women considered oral contraceptives effective and easy to use, only one-third preferred pills, and less than half thought that oral contraceptives were safe. Unfortunately, only 36% of the participants were aware that some medications could affect pill efficacy. Moreover, less than half of the women knew that missed doses should be retaken. Ineligibility for oral contraceptives was detected in a few participants. The results obtained revealed an inadequate level of knowledge of the Lebanese women regarding the use, safety, and efficacy of oral contraceptives, and this might have contributed to their negative attitude towards the use of pills

PSYCHOMETRIC EVALUATION OF THE ADHERENCE TO REFILLS AND MEDICATIONS SCALE (ARMS) AMONG ADULTS PATIENTS WITH CHRONIC DISEASE: THE LEBANESE VERSION

Background: Non-adherence to medications can lead to several consequences that range from waste of drugs to death. Consequently, a tool to assess the adherence to chronic medication is a necessity. Objectives: The purpose of this study was to conduct the translation and cross-cultural adaptation process of ARMS into the Lebanese Arabic version (ARMS-A) and to examine its psychometric properties (validity and reliability assessment). Design: The original English version of ARMS was translated into Arabic based on the established guidelines. Eight expert panels were involved in content validation, while face validation was conducted on twenty participants during pilot testing. A cross-sectional survey was used to evaluate the psychometric properties of ARMS-A on 135 participants. Participants: Adults patients on chronic medications were invited to be part of the study. Main outcome measures: Overall content and universal face validity indexes were determined in addition to the exploratory factors and Cronbach’s alpha. Key Results: The overall content validity index was 0.91, and the universal face validity index was also 0.91. For the exploratory factor analysis, two factors were extracted. The first one consisted of 6 items and explained 43.9% of the variance. The second one also comprised of 6 items with a variance of 9.59%. For internal consistency and reliability, the Cronbach’s alpha was 0.877. Conclusion: ARMS-A appears to be a valid and reliable medication adherence tool to assess the adherence of chronic medications among native Arabic speaking patient with chronic diseases

ASSESSMENT OF THE KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARDS EXPIRED DRUG DISPOSAL AMONG THE COMMUNITY IN BEIRUT CITY, LEBANON

The global increase in pharmaceutical spending has led to enhanced international awareness of the unused and expired drug issues due to improper drug disposal\u27s harmful economic, environmental, and health effects. Consequently, the study was conducted to assess the knowledge, attitude, and practice toward expired drug disposal among the community in Beirut City, Lebanon. A cross-sectional, observational, questionnaire-based study was conducted. Data were analyzed using SPSS version 23. The fact that improper disposal of expired medicine affects the environment and health was acknowledged by 70.7% of the 450 participants. Even though 72.2% of the participants knew that the best method for drug disposal was medication disposal boxes, 50.4% did not know about the use of the drug take-back system. Expired drugs were present in 71.1% of the participants’ homes, and 78.9% of the participants discarded them in household garbage. In fact, 53.6% agreed that there is a lack of adequate information on the safe disposal of expired household medicines. This study revealed a lack of proper advice on the safe disposal of expired medicines. Consequently, the government should initiate feasible expired drug programs to educate the public. Improper disposal of expired drugs has a negative impact on the environment. The current study revealed that 78.9% of the participants discards expired drugs in an improper way. Accordingly, actions should be taken to save the planet

Analgesia additive interaction between tadalafil and morphine in an experimental animal model

Since both morphine and tadalafil have been proven to exert some of their analgesic activity through modulation of the NO–cGMP pathway, the aim of the current study is to evaluate the pharmacologic interaction between tadalafil and morphine to decrease the dose of morphine and subsequently its side effects. The assessment was carried out through isobolographic analysis relative to ED50s of both morphine and tadalafil obtained by tail-flick test on BALB/c mice. Morphine and tadalafil ED50s calculated from the dose–response curves were 8303 and 2080 μg/kg, respectively. The experimental ED50 values of morphine and tadalafil in their mixture were 4800 and 1210 μg/kg, respectively. Those results showed an additive interaction between morphine and tadalafil presented by a total fraction value for the mixture of 1160 μg/kg. This outcome can be interpreted by the fact that both drugs share common pathways, namely, NO–cGMP and opioid receptors. As a conclusion, the morphine and tadalafil combination showed an additive effect against acute pain, which is mediated through the central nervous system, thus providing a rationale for combining them to decrease morphine dose and thus minimizing its side effects.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author