A young child with HIV and unsteady gait: A case report

Background: We would like to raise awareness about the toxicities related to the added excipients present in the oral solution of Liponavir/ritonavir in particular alcohol and propylene glycol. Case presentation: In this case report, we describe an 18 month-old child with a newly diagnosed HIV infection on antiretroviral therapy (ART). She developed shortly after starting the ART unsteady gait and imbalance. Conclusions: The excipient-excipient interaction in Lopinavir/ritonavir may contribute to major toxicities not only in premature neonates and infants; but also in older children specifically from Asian ethnicity. Keywords: HIV, Lopinavir-ritonavir, Unsteady gai

Knowledge, attitudes, and practices of pediatricians in relation to breastfeeding support: A national survey in Lebanon.

BackgroundRates of breastfeeding (BF) remain suboptimal despite overwhelming evidence for its benefits to the mother and child. Pediatricians play an important role in supporting breastfeeding (BF). In Lebanon, the rates of both exclusive and continued BF are critically low. The objective of this study is to examine the knowledge, attitudes and practices (KAP) of Lebanese pediatricians in relation to supporting BF.MethodsA national survey of Lebanese pediatricians was conducted through Lime Survey (n = 100, response rate 9.5%). The list of pediatricians' emails was obtained from the Lebanese Order of Physicians (LOP). Participants completed a questionnaire covering, in addition to sociodemographic characteristics, the KAP, related to supporting BF. Descriptive statistics and logistic regressions were used in data analysis.ResultsThe most prevalent gaps in knowledge were related to the positioning of the baby during BF (71.9%) and the association between the mother's fluid intake and her milk production (67.4%). With regards to attitudes, 34% of participants reported unfavorable attitudes towards BF in public and BF while working (25%). As for practices, more than 40% of pediatricians kept formula samples and 21% had formula-related advertising in their clinics. Half of the pediatricians reported rarely/never referring mothers to lactation consultants. After adjustment, both being a female pediatrician and having done the residency in Lebanon were significant predictors of better knowledge (OR = 4.51 (95%CI: 1.72-11.85) and OR = 3.93 (95%CI: 1.38,11.19) respectively.ConclusionThis study revealed important gaps in the KAP related to BF support among Lebanese pediatricians. Coordinated efforts ought to be exerted to educate and equip pediatricians with needed knowledge and skills to support BF

Knowledge, attitudes, and practices of pediatricians in relation to breastfeeding support: A national survey in Lebanon

Background Rates of breastfeeding (BF) remain suboptimal despite overwhelming evidence for its benefits to the mother and child. Pediatricians play an important role in supporting breastfeeding (BF). In Lebanon, the rates of both exclusive and continued BF are critically low. The objective of this study is to examine the knowledge, attitudes and practices (KAP) of Lebanese pediatricians in relation to supporting BF. Methods A national survey of Lebanese pediatricians was conducted through Lime Survey (n = 100, response rate 9.5%). The list of pediatricians' emails was obtained from the Lebanese Order of Physicians (LOP). Participants completed a questionnaire covering, in addition to sociodemographic characteristics, the KAP, related to supporting BF. Descriptive statistics and logistic regressions were used in data analysis. Results The most prevalent gaps in knowledge were related to the positioning of the baby during BF (71.9%) and the association between the mother's fluid intake and her milk production (67.4%). With regards to attitudes, 34% of participants reported unfavorable attitudes towards BF in public and BF while working (25%). As for practices, more than 40% of pediatricians kept formula samples and 21% had formula-related advertising in their clinics. Half of the pediatricians reported rarely/never referring mothers to lactation consultants. After adjustment, both being a female pediatrician and having done the residency in Lebanon were significant predictors of better knowledge (OR = 4.51 (95%CI: 1.72-11.85) and OR = 3.93 (95%CI: 1.38,11.19) respectively. Conclusion This study revealed important gaps in the KAP related to BF support among Lebanese pediatricians. Coordinated efforts ought to be exerted to educate and equip pediatricians with needed knowledge and skills to support BF. Copyright

Knowledge, attitudes, and practices of pediatricians in relation to breastfeeding support: A national survey in Lebanon

Background Rates of breastfeeding (BF) remain suboptimal despite overwhelming evidence for its benefits to the mother and child. Pediatricians play an important role in supporting breastfeeding (BF). In Lebanon, the rates of both exclusive and continued BF are critically low. The objective of this study is to examine the knowledge, attitudes and practices (KAP) of Lebanese pediatricians in relation to supporting BF. Methods A national survey of Lebanese pediatricians was conducted through Lime Survey (n = 100, response rate 9.5%). The list of pediatricians’ emails was obtained from the Lebanese Order of Physicians (LOP). Participants completed a questionnaire covering, in addition to sociodemographic characteristics, the KAP, related to supporting BF. Descriptive statistics and logistic regressions were used in data analysis. Results The most prevalent gaps in knowledge were related to the positioning of the baby during BF (71.9%) and the association between the mother’s fluid intake and her milk production (67.4%). With regards to attitudes, 34% of participants reported unfavorable attitudes towards BF in public and BF while working (25%). As for practices, more than 40% of pediatricians kept formula samples and 21% had formula-related advertising in their clinics. Half of the pediatricians reported rarely/never referring mothers to lactation consultants. After adjustment, both being a female pediatrician and having done the residency in Lebanon were significant predictors of better knowledge (OR = 4.51 (95%CI: 1.72–11.85) and OR = 3.93 (95%CI: 1.38,11.19) respectively. Conclusion This study revealed important gaps in the KAP related to BF support among Lebanese pediatricians. Coordinated efforts ought to be exerted to educate and equip pediatricians with needed knowledge and skills to support BF

Ellis-van Creveld Syndrome: Mutations Uncovered in Lebanese Families

Background. Ellis-van Creveld (EvC) syndrome is a rare, autosomal recessive disorder characterized by short stature, short limbs, growth retardation, polydactyly, and ectodermal defects with cardiac anomalies occurring in around 60% of cases. EVC syndrome has been linked to mutations in EVC and EVC2 genes. Case Presentation. We report EvC syndrome in two unrelated Lebanese families both having homozygous mutations in the EVC2 gene, c.2653C>T (p.(Arg885*)) and c.2012_2015del (p.(Leu671*)) in exons 15 and 13, respectively, with the latter being reported for the first time. Conclusion. Although EvC has been largely described in the medical literature, clinical features of this syndrome vary. While more research is required to explore other genes involved in EvC, early diagnosis and therapeutic care are important to achieve a better quality of life

Liban

Le Liban est au carrefour de la Méditerranée et de l'Orient arabe. Il concrétise une longue histoire naturelle de la construction des paysages levantins jusqu'à leurs façonnements par l’Homme depuis l’Holocène jusqu'à 21e siècle. Ce numéro spécial propose au travers les six articles, des lectures historiques et contemporaine de la transformation des territoires dans sa capitale Beyrouth, dans son espace montagnard et sa plaine agricole. Dans un premier volet, les transformations de l’espace urbain à Beyrouth sont décrites au travers l’occidentalisation des espaces publics depuis la fin du 19e siècle, suivies d’une étude morpho-dynamique à une échelle fine du tissu du bâti de la ville depuis 1950. Dans un deuxième volet, le Mont-Liban a connu aussi une recomposition territoriale de son espace reflétant une mobilité des populations et leurs adaptations depuis le Néolithique jusqu’aux époques historiques. Une étude de cette recomposition politique du territoire montagnard depuis 1975 repositionne le Mont-Liban entre espace « refuges » et espace « mondialisé ». Le dernier volet se focalise sur la plaine agricole de la Beqaa, les transformations de son occupation du sol ainsi que les stratégies d’adaptations adoptées face aux défis accrus de sécheresse. Lebanon is at the crossroads of the Mediterranean basin and the Middle-East. The country’s landscape reflects a variety of ecosystems, topography and micro-climate. Located at the crossroads of human dispersal routes, the landscape is hampered by human activity since the Neolithic time. This issue proposes different case studies regarding territorial transformation divided into three thematic parts. First, the transformation of the urban spaces in Beirut are described through the westernization of public spaces since the end of the 19th century followed by a morpho-dynamic study of the urban fabric of the city since 1950. Second, the mountainous areas of Lebanon were also impacted by human activity and mobility since the Neolithic. A first case study on spatial pattern of human occupation in Mount Lebanon describe the population dynamics and the adaptation strategies adopted in an archeological site. A second case study describe the political transformation of the Mount-Lebanon since 1975 to examine the mountain territory role between a "refuge" and a "globalized" space. The last part focuses on the agricultural sector in the Beqaa plain with two cases studies, one on the drought monitoring since 2001 and the other on land and water uses strategies followed by farmers to cope with drought challenges