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Azzi V, Malaeb D, Khatib SE, Sakr F, Dabbous M, Hallit S, Soufia M. Association of behaviors and asthma control in a sample of Lebanese adolescents with asthma. Allergol Immunopathol (Madr) 2024; 52:51-59. [PMID: 38459891 DOI: 10.15586/aei.v52i2.1057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/08/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND The relationship between behavioral problems and asthma is bidirectional; while the presence of a chronic disease such as asthma might predispose the person to stress, anxiety, and other behavioral issues, behavioral problems might in turn cause uncontrolled asthma through nonadherence to asthma management strategies. In Lebanon, behavioral problems and uncontrolled asthma could be of significant concern for adolescents. Consequently, we found it necessary to evaluate association between behavioral problems and uncontrolled asthma in a sample of Lebanese adolescents. METHODS Data for this cross-sectional study were collected using the snowball sampling technique in July 2023. The questionnaire was developed with Google Forms and distributed to participants via social media platforms and messaging applications. The Asthma Control Test (ACT) was used to check for uncontrolled asthma, and the Youth Self-Report (YSR) scale was used to assess behavioral problems. It yields nine subscales (anxious-depressed, withdrawn-depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior, and other problems) and a total score. RESULTS When taking each behavior score as an independent variable, older age was associated with lower ACT scores (more controlled asthma); F(15, 186) = 3.66, P = 0.014, and 95% Confidence Interval (CI) [-0.85, -0.10]. Living in a rural area, compared to urban was associated with higher ACT scores, P = 0.018, and 95% Confidence Interval (CI) [0.28, 2.94]. The intake of the COVID-19 vaccine, P = 0.003 and 95% CI [0.73, 3.55]; waterpipe smoking, P = 0.017 and 95% CI [0.38, 3.85]; and having more somatic complaints, P = 0.005 and 95% CI [0.04, 0.25], also were significantly associated with higher ACT scores (more uncontrolled asthma). When taking the total behavior score as an independent variable, higher YSR scores were associated with higher ACT scores (more uncontrolled asthma), F(10, 191) = 4.30, P = 0.038, and 95% CI [0.003, 0.10]. CONCLUSION Our findings support the inclusion of mental health treatments for better asthma control and point to a link between behavioral issues and uncontrolled asthma. In a developing nation without a clear established strategy for asthma prevention, the findings of this study could help develop potentially beneficial public health treatments.
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Affiliation(s)
- Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan;
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
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Kharaba Z, Feghali E, El Husseini F, Sacre H, Abou Selwan C, Saadeh S, Hallit S, Jirjees F, AlObaidi H, Salameh P, Malaeb D. An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study. Front Public Health 2022; 10:883784. [PMID: 36117601 PMCID: PMC9477115 DOI: 10.3389/fpubh.2022.883784] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/07/2022] [Indexed: 01/21/2023] Open
Abstract
Background Asthma is a prevalent hyperactive airway disease with physical and emotional impact. Severe asthma is associated with considerable health-related quality of life (HRQoL). The aim of this study is to assess the quality of life through physical, emotional, social and occupational aspects and evaluate the factors affecting HRQoL in patients with asthma. Methods This is a cross-sectional multicenter study conducted on adult asthmatic patients enrolled from community pharmacies across different Lebanese geographic areas. Results Having wheezing sometimes and most of the time (Beta = -0.144 and -0.552), experiencing anxiety sometimes and most of the time (Beta = -0.205 and -0.573), encountering sleep problems sometimes and most of the time (Beta = -0.270 and -0.553), having previous chest discomfort sometimes and most of the time (Beta = -0.421 and -0.713), and having depression most of the times (Beta = -0.415) were associated with higher lower quality of life scores. On the other side, holding a secondary level of education was associated with a higher quality of life score (Beta = 0.192). Conclusion This study highlights that asthma affects adults' quality of life through social, emotional, physical, and occupational impacts. Improved follow-up and patient education may be essential in the future to stop disease progression and achieve ideal therapeutic outcomes.
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Affiliation(s)
- Zelal Kharaba
- Department of Clinical Sciences, College of Pharmacy, Al-Ain University of Science and Technology, Abu Dhabi, United Arab Emirates,Al Ain University Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, United Arab Emirates
| | - Emilie Feghali
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Farah El Husseini
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Carla Abou Selwan
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Sylvia Saadeh
- Life Sciences and Health Department, Paris-Est University, Paris, France,Health and Sciences Department, American University of Health and Sciences, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia,Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Hala AlObaidi
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon,School of Medicine, Lebanese American University, Byblos, Lebanon,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon,College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates,*Correspondence: Diana Malaeb
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Al-Zayadneh EM, Arafah ADE, Ibrahim SM, Glessa MA, Al-Iede M. Quality of Life Questionnaires for Children With Bronchial Asthma at Jordan University Hospital: An Observational Study. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x16999201009155509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Asthma is a common chronic illness worldwide. Identifying and treating
impaired health-related quality of life, is now recognized as an important component of asthma management.
A high prevalence of behavioral and emotional difficulties was noticed among children
with asthma.
Methods:
This is a cross-sectional study that was conducted over 8 weeks involving 45 asthmatic
children, between the ages of 7-17 years old, presented to Jordan University Hospital in Amman,
Jordan. General demographic characteristics were collected, and two questionnaires were used:
asthma control test (ACT), and the pediatric asthma quality of life questionnaire (PAQLQ). We also
used the feeling thermometer scale, and a pulmonary function test was done for patients. SAS
Software version 9.4 USA and Pearsons coefficient were used to find associations.
Results:
Among 45 patients, 53% of the sample had poor asthma control. The mean FEV1 on lung
function testing was 80% (± 16.18) of predicted. The mean for clinical asthma scores (ACT) was
18.8 ± 4.53 (out of 25). FEV1 was significantly higher in children with good control compared to
those with a low ACT score (P-value <0.05). The mean total PAQLQ score was 5.3 ± 1.06 and it
correlated significantly with ACT score (P-value <0.001).
Conclusion:
This study highlights the association of poorly controlled asthma with a poor quality
of life. It is recommended that the quality of life of children should be assessed and observed during
clinic visits, for a better comprehensive approach and effective improvement of outcome.
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Affiliation(s)
- Enas M. Al-Zayadneh
- Department of Pediatrics, School of Medicine, University of Jordan, Queen Rania Street, Jubaiha, Amman, Jordan
| | | | | | | | - Montaha Al-Iede
- Department of Pediatrics, School of Medicine, University of Jordan, Queen Rania Street, Jubaiha, Amman, Jordan
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Malaeb D, Hallit S, Sacre H, Hallit R, Salameh P. Factors associated with wheezing among Lebanese children: Results of a cross-sectional study. Allergol Immunopathol (Madr) 2020; 48:523-529. [PMID: 32402625 DOI: 10.1016/j.aller.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND In Lebanon, asthma is underdiagnosed due to low access to healthcare, particularly in rural areas, although asthma diagnosis in children is based mainly on clinical symptoms. Thus, wheezing might be more suggestive of undiagnosed respiratory diseases including asthma in Lebanese children. This study aimed to determine the factors associated with wheezing in Lebanese children without asthma diagnosis. METHODS This cross-sectional study was conducted between December 2015 and April 2016, enrolling a total of 1203 schoolchildren. RESULTS Out of 1500 prepared questionnaires, 1380 questionnaires were distributed in schools, and 1203 (87.17%) were collected back from the parents of children aged between 4-17 years old. The sample included 42 (3.5%) [95% CI 0.025-0.045] children with reported chronic wheezing. A multivariable analysis was performed taking the presence versus absence of wheezing in children as the dependent variable. The results showed that spraying pesticides at home (aOR=1.91), presence of humidity at home (aOR=2.21) and child reflux (aOR=2.60) were significantly associated with the presence of wheezing in children. CONCLUSION The findings of the study suggest that certain environmental factors, such as pesticides, humidity at home and reflux disease, might be associated with wheezing episodes in children. Those factors can be prevented through raising awareness by health care professionals.
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Hasan S, Mahameed S. Assessing Patient Knowledge of Asthma Using a Newly Validated Tool. Value Health Reg Issues 2020; 22:108-114. [PMID: 32828005 DOI: 10.1016/j.vhri.2020.07.576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/13/2020] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To develop and validate a measure of asthma knowledge and to translate and culturally adapt the measure into the Arabic language and context. METHODS Medically diagnosed individuals 18 years and older were recruited in primary care and specialty asthma clinics in the United Arab Emirates. The National Asthma Education and Prevention Program recommendations for education on asthma were used as a framework to develop the Asthma Knowledge Test (AKT). A measurement scale of "Yes," "No," and "I don't know" was selected. Descriptive statistics were calculated for participant demographics and other healthcare information. Cronbach α ≥ 0.7 was used to measure reliability. Principal component analysis was used to determine the distinct areas of asthma knowledge covered by the AKT. Differences in asthma knowledge depending on sex, age, marital status, and education were tested using multivariate analyses of variance. RESULTS Cronbach α = .70. Four components were retained and included: asthma as a common disease, triggers and control issues, inhalers, and beliefs and myths. The average AKT score = 13.95 ± 2.77 (range = 5.0-18.0). There was a significant effect of participant level of education on the AKT scores. CONCLUSIONS The availability of the AKT in Arabic is a valuable addition to the limited available tools related to asthma. As a simple and short tool, it could be used in clinical practice and research to identify specific areas of patient asthma knowledge needing improvements; hence, targeted interventions are sought.
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Affiliation(s)
- Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy & Health Sciences, Ajman University, Ajman, United Arab Emirates.
| | - Shrouq Mahameed
- Department of Clinical Sciences, College of Pharmacy & Health Sciences, Ajman University, Ajman, United Arab Emirates
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Miao Q, Xiang L, Guan H, Liu Y, Li Z, Ren Y, Xu W. Factors related to disagreement between self-reported versus objective measurement of allergen sensitization at a tertiary pediatric center in Beijing, China. BMC Pediatr 2020; 20:259. [PMID: 32466755 PMCID: PMC7254731 DOI: 10.1186/s12887-020-02148-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The objectives of present study were to examine the level of disagreement between self-reported and objective measurement of sensitization to common inhalant allergens, and to explore the potential risk factors that might contribute to this discrepancy. METHODS A total of 215 children were enrolled from pediatric clinics at a tertiary pediatric center in Beijing, China. A survey questionnaires regarding self-perceived sensitization was completed by participants' parents/caregiver, meanwhile, skin prick testing(SPT) was performed as objective assessment of sensitization. Extent of agreement between self-reported versus SPT-measured sensitization to individual allergen was calculated using Cohen's kappa (κ) coefficient. Multivariable regression analyses were used to determine the factors associated with discrepancy between self-reported and objective measurement of sensitization. RESULTS 119(55.3%) patients have reported to be sensitized to at least one of inhalant allergen, whereas 167(77.7%) patients had a positive skin testing response. Agreement between self-perceived and actual aeroallergen sensitization was moderate for mites(κ = 0.518) and grass pollen mix(κ = 0.451), moreover, fair agreement was observed for mold(κ = 0.316) and cockroach(κ = 0.297), respectively. There was a least agreement between perceived and actual sensitization observed for pet dander, with a kappa coefficient of 0.005. Subjects' age, atopy history, ownership of pet may increase the risk of disagreement, moreover, background factors of informant, like: age, education level, and the relationship with enrolled subjects, were linked to the incidence of disagreement between self-reported sensitization in comparison with SPT results. CONCLUSION Questionnaire-based self-assessment is easy way to collect clinical information on allergen sensitization; however, the accuracy of questionnaire-derived information is more likely to be influenced by respondent's background factors. The information from the questionnaire report is considered to be more reliable when in combination with objective assessment of sensitization, including blood IgE testing and SPT.
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Affiliation(s)
- Qing Miao
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China.
| | - Li Xiang
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China.
| | - Hui Guan
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China
| | - Yongge Liu
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China
| | - Zhen Li
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China
| | - Yixin Ren
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China
| | - Wei Xu
- Department of Allergy, Beijng Children's Hospital, Capital Medical Univeristy, National Center for Children's Health, Beijing, 100045, People's Republic of China
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Abiad HF, Alameddine VM, Hallit S, Torbey PH, Mroueh S, Yazbek N, Asmar E, Hage P, Fares GA, Samarani M, Khalife MCF. Aeroallergen sensitization in Lebanese asthmatic children: the results of a cohort national study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:5597-5605. [PMID: 31858416 DOI: 10.1007/s11356-019-07234-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
Atopic asthma is characterized by the presence of sensitization to common aeroallergens, which tends to have a worse prognosis than non-atopic asthma. The objectives were to determine the prevalence of aeroallergens sensitization in the Lebanese pediatric asthmatic population and determine the relationship between allergens sensitization (indoor and outdoor) and age, area of residence and altitude. A sample, consisting of 919 asthmatic children (aged 1 to 18 years, from 2010 until 2017), underwent skin prick testing (SPT) with 21 common allergens: 5 grasses (cocksfoot, sweet vernal-grass, rye-grass, meadow grass, timothy), Parietaria, olive, Dermatophagoides pteronyssinus and Dermatophagoides farina (DP-DF), dog and cat dander, Alternaria longipens, Aspergillus fumigatus and nidulans, Cupressaceae, pine, German cockroach, and 4 cereals (oat, wheat, barley, maize). Seven hundred fifty-two patients had positive SPT. The distribution of sensitization was as follows: DP-DF 59%; 5 grasses 34%; 4 cereals 33.9%; cat 29.9%; Alternaria 27.9%; Parietaria 23%; dog 21.9%; olive 20.5%; Aspergillus mix 18.6%; Cupressaceae 18.2%; pine 17%; cockroach 15.3%. House dust mites sensitization was frequent at lower altitude (< 900 m) (56.3%) and in the whole country (a median prevalence of 53.05%) except for the Beqaa region (negative HDM in 82.4%). Non-atopic asthma was more frequent in early childhood (40.5% at 1-4 years vs 11.2% at 11-18 years). The sensitization rate increased with age, starting at 5 years. Higher age (aOR = 1.24) and altitude less than 900 m compared with ≥ 900 m (aOR = 2.03) were significantly associated with the presence of aeroallergens in children. House dust mites and grasses are the most common allergens in Lebanese asthmatic children. Non-atopic asthma is more frequent at early age. Lebanese children with asthma showed a polysensitized pattern starting at 5 years.
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Affiliation(s)
- Hala Feghali Abiad
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | | | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Paul-Henry Torbey
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | - Salman Mroueh
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | - Nelly Yazbek
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | - Edgard Asmar
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | - Pierre Hage
- Faculty of Medicine, University of Balamand, Beirut, Lebanon
- Asthma Center of the Childhood Protection and Care, Association in Beirut, Hazmieh, Lebanon
| | - George Abi Fares
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Marie Samarani
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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Uncovering Demographic, Clinical, Triggering Factors Similarities Between Migraine and Irritable Bowel Syndrome: A Prospective Study. J Nerv Ment Dis 2019; 207:847-853. [PMID: 31503173 DOI: 10.1097/nmd.0000000000001033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The objective was to uncover demographical and clinical factors associated with migraine and irritable bowel syndrome (IBS) in a group of patients experiencing both painful disorders and to identify their triggering factors. A prospective study was performed between January 2016 and June 2017. Clinical characteristics and potential generating factors for both pathologies were then assessed using validated questionnaires. Our study showed that the percentage of patients diagnosed with migraine and having IBS was 34.3%. Compared with patients with migraine alone, patients having both diseases were identified with higher prevalence of concomitant chronic/psychiatric diseases, lower frequency of migraine attacks, and lower prevalence of throbbing/distressing/enervating pain and concentration difficulties than patients with migraine alone. Moreover, patients in this subgroup had moderate abdominal pain intensity, and constipation was the predominant stool type. Finally, some dietary and environmental factors seem to be significantly important triggering factors of migraine/IBS pain.
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Malaeb D, Hallit S, Sacre H, Malaeb B, Hallit R, Salameh P. Diet and asthma in Lebanese schoolchildren: A cross-sectional study. Pediatr Pulmonol 2019; 54:688-697. [PMID: 30920185 DOI: 10.1002/ppul.24280] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/24/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The causes of the global increase in asthma in children are unknown. It has been hypothesized that diet is an important factor that may play a role in the pathogenesis of the disease. The objective was to evaluate the association between diet and current asthma among Lebanese children. METHODS A cross-sectional study was conducted on 1000 children recruited from public and private schools in Lebanon. Of the total enrolled participants, 107 children were diagnosed with current asthma and were analyzed. The food frequency questionnaire was used to assess participants' dietary habits. RESULTS The consumption of sweets ≥3 times weekly (ORa = 5.42), white bread ≥3 times weekly (ORa = 26.38), and olive oil daily (ORa = 9.80) were associated with higher odds of current asthma. Drinking carbonated beverages occasionally (ORa = 0.25) and ≥3 times per week (ORa = 0.03) was significantly associated with lower odds of current asthma. Adhering to Mediterranean diet (occasional, >3 times weekly and daily) was significantly associated with lower odds of current asthma compared to never consuming Mediterranean diet (ORa = 0.23 and ORa = 0.22, respectively). The occasional consumption of bread was significantly associated with higher odds of current asthma (ORa = 8.2), whereas daily consumption was significantly associated with lower odds (ORa = 0.336). Moreover, the occasional, ≥3 times weekly and daily consumption of meat were significantly associated with higher odds of current asthma (ORa = 9.6; ORa = 5.1 and ORa = 4.5), respectively. An occasional consumption of junk food was significantly associated with lower odds of current asthma (ORa = 0.044), whereas a daily consumption was associated with higher odds. CONCLUSION Adhering to certain diets might be associated with higher odds of current asthma.
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Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists in Lebanon, Beirut, Lebanon
| | | | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- Life Sciences and Health Department, Paris-Est University, Paris, France.,Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.,Faculty of Medicine, Lebanese University, Hadath, Lebanon
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Hallit S, Raherison C, Malaeb D, Hallit R, Waked M, Kheir N, Salameh P. Development of an asthma risk factors scale (ARFS) for risk assessment asthma screening in children. Pediatr Neonatol 2019; 60:156-165. [PMID: 29983338 DOI: 10.1016/j.pedneo.2018.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/16/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The study objective was to create asthma risk factors scale (ARFS) score that would be correlated with the increased risk of asthma in Lebanese children. This scale would eventually be used both to identify children at risk and assess early diagnosis of asthma. METHODS A case-control study (study 1) of 1276 children (976 controls and 300 cases) and a cross-sectional study (study 2) of 1000 children were conducted using a parental questionnaire. Children aged between 3 and 16 years were screened for possible enrollment. The ARFS was created by combining the following risk factors: child's exposure to pesticides, detergent mixing, alcohol, smoking and drug intake during pregnancy and breastfeeding, the actual paternal and maternal smoking status and history of asthma, and the types of food the child consumes. RESULTS There was a significant increase in the risk assessment screening for asthma per 15 points increments of ARFS (p < 0.001 for trend). The score category 0-14.99 best-represented control individuals (88.8% controls), while a score higher than 45 represented asthmatic children best (98.4% asthmatics). The positive predictive value (disease positive/all positive by scale) came out as 94.02%, whereas the negative predictive value (disease negative/all negative by scale) was found to be 90.47%. These results were confirmed in the second study sample. CONCLUSION The ARFS is a simple and easy-to-use tool, composed of 15 questions, for the clinician risk assessment of asthma in children, taking into account the environmental exposure, parental history of asthma and dietary habits of the child. Its value for asthma diagnosis remains to be confirmed in future prospective studies, especially in children with chronic respiratory symptoms.
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Affiliation(s)
- Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon; Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon.
| | - Chantal Raherison
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; Department of Pneumology, University Hospital, Bordeaux, France
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Mirna Waked
- Faculty of Medicine, Balamand University, Koura, Lebanon
| | - Nelly Kheir
- Faculty of Science II, Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon; Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Banjari M, Kano Y, Almadani S, Basakran A, Al-Hindi M, Alahmadi T. The Relation between Asthma Control and Quality of Life in Children. Int J Pediatr 2018; 2018:6517329. [PMID: 30057631 PMCID: PMC6051244 DOI: 10.1155/2018/6517329] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/20/2018] [Accepted: 05/30/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. METHODS Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson's chi-square and independent sample t-tests were used to find associations. RESULTS Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58). CONCLUSION The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.
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Affiliation(s)
- M. Banjari
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Y. Kano
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - S. Almadani
- King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - M. Al-Hindi
- Department of Pediatrics, King Saud Bin Abdul Aziz University for Health Sciences, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
| | - T. Alahmadi
- Department of Paediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
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Bacha ZA, Layoun N, Khayat G, Allit S. Factors associated with smoking cessation success in Lebanon. Pharm Pract (Granada) 2018; 16:1111. [PMID: 29619139 PMCID: PMC5881483 DOI: 10.18549/pharmpract.2018.01.1111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/27/2018] [Indexed: 11/14/2022] Open
Abstract
Objective: The objective is to assess factors associated with the success rate of smoking cessation among Lebanese smokers in a smoking cessation center. Methods: A cross-sectional data study, conducted between March 2014 and March 2016 in an outpatient smoking cessation center with 156 enrolled patients. The patient’s nicotine dependence and motivation to quit smoking were evaluated according to the Fagerstrom Test for Nicotine Dependence and Richmond tests respectively. Results: The number of packs smoked per year decreased the odds of smoking cessation success (p=0.004, ORa=0.982, CI 0.97-0.994), while the compliance with the offered treatment increased the odds of success by 7.68 times (p<0.001, ORa=7.68, CI 3.438-17.187). Highly dependent and highly motivated smokers had more success in the quitting process compared to those with a lower dependence and motivation respectively. Conclusion: Our findings showed that many factors can influence smoking cessation, an experience described as difficult, most significantly the number of packs per year and compliance with the smoking cessation treatment. Moreover, although these outcomes are not representative of the entire Lebanese population, we believe that health authorities could utilize these results when implementing upcoming smoking cessations programs. All attempts at cessation should have a goal of reducing the number of packs smoked per year to improve the chances of ceasing into the future.
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Affiliation(s)
- Zeina A Bacha
- Attending and Assistant Professor. Department of Pulmonology and Tobaccology, Hotel Dieu de France Hospital and Saint Joseph University. Beirut (Lebanon).
| | - Nelly Layoun
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles. Brussels (Belgium).
| | - Georges Khayat
- Attending and Assistant Professor. Department of Pulmonology and Tobaccology, Hotel Dieu de France Hospital and Saint Joseph University. Beirut (Lebanon).
| | - Souheil Allit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib; & Faculty of Medicine and Medical Sciences, Holy Spirit University. Kaslik (Lebanon).
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Hallit S, Raherison C, Waked M, Hallit R, Layoun N, Salameh P. Validation of the mini pediatric asthma quality of life questionnaire and identification of risk factors affecting quality of life among Lebanese children. J Asthma 2018. [PMID: 29513606 DOI: 10.1080/02770903.2018.1441417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Few studies used various scales to assess the QOL in Lebanon in general but none was specific to asthma. Our objective was to assess the asthma-related quality of life, using the mini Pediatric Asthma Quality of Life Questionnaire (PAQLQ), in Lebanese asthmatic children, check its validity compared to the original version, and identify clinical and sociodemographic risk factors that might affect these children's QOL. METHODS This retrospective study included 300 children aged between 7-16 years (51.6% boys and 48.4% girls). To confirm the mini-PAQLQ questionnaire construct validity in the Lebanese population, an exploratory factor analysis was launched for the 13 items of the questionnaire, using the principal component analysis technique. Cronbach's alpha was recorded for reliability analysis. A multivariate analysis linear regression was carried out, taking the QOL score as the dependent variable. RESULTS The correlation coefficients for factors 1 (symptoms and emotions) and 2 (activities) were similar to that of the original scale. High Cronbach's alphas were found for factor 1 (0.914), factor 2 (0.888), and the full scale (0.921). Uncontrolled asthma, the child's respiratory problems before the age of 2 years, and the presence of pets at home significantly decreased the children's asthma-related quality of life (Beta = -1.541; Beta = -6.846, and Beta = -5.364, respectively). CONCLUSION We were able to validate the mini-PAQLQ among the Lebanese population. The identification of risk factors, some of which are amenable to intervention, especially uncontrolled asthma, could lead to an improvement in the asthmatic children's QOL.
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Affiliation(s)
- Souheil Hallit
- a Faculty of Pharmacy , Lebanese University , Beirut , Lebanon.,b Faculty of Pharmacy , Saint-Joseph University , Beirut , Lebanon.,c Faculty of Medicine and Medical Sciences , Holy Spirit University Kaslik , Kaslik , Lebanon.,d Research Department , Psychiatric Hospital of the Cross , Jal Eddib , Lebanon.,e Occupational Health Environment Research Team, BPH Bordeaux Population Health Research Center Inserm , Universite de Bordeaux , Bordeaux , France.,f INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health , Lebanese University , Beirut , Lebanon
| | - Chantal Raherison
- e Occupational Health Environment Research Team, BPH Bordeaux Population Health Research Center Inserm , Universite de Bordeaux , Bordeaux , France.,g Department of Pulmonology , University Hospital of Bordeaux , Bordeaux , France
| | - Mirna Waked
- h Faculty of Medicine , Balamand University , Koura , Lebanon
| | - Rabih Hallit
- c Faculty of Medicine and Medical Sciences , Holy Spirit University Kaslik , Kaslik , Lebanon
| | - Nelly Layoun
- a Faculty of Pharmacy , Lebanese University , Beirut , Lebanon.,f INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health , Lebanese University , Beirut , Lebanon
| | - Pascale Salameh
- a Faculty of Pharmacy , Lebanese University , Beirut , Lebanon.,f INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health , Lebanese University , Beirut , Lebanon.,i Faculty of Medicine , Lebanese University , Beirut , Lebanon
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14
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Hallit S, Raherison C, Malaeb D, Hallit R, Kheir N, Salameh P. The AAA Risk Factors Scale: A New Model to Screen for the Risk of Asthma, Allergic Rhinitis and Atopic Dermatitis in Children. Med Princ Pract 2018; 27:472-480. [PMID: 29879703 PMCID: PMC6243911 DOI: 10.1159/000490704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/07/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To create an allergic disease risk factors scale score that would screen for the risk assessment of asthma, allergic rhinitis and atopic dermatitis (AD) in children from 3 to 17 years. METHODS This case-control study, conducted between December 2015 and April 2016, enrolled 1,274 children. The allergic disease risk factors scale was created by combining environmental, exposure to toxics during pregnancy and breastfeeding and parental history of allergic diseases. RESULTS Playing on carpets, male gender, child's respiratory problems or history of eczema before the age of 2 years, and humidity significantly increased the odds of allergies in the child. Maternal waterpipe smoking, maternal history of rhinitis, history of asthma in the mother or the father, along with the maternal drug intake or alcohol consumption during pregnancy significantly increased the odds of allergies in the child. There was a significant increase in allergy diseases per category of the allergic disease risk factors scale (p < 0.001 for trend). Scores ≤2.60 best represented control individuals, while scores > 5.31 best represented children with allergic diseases. CONCLUSION Allergic diseases seem to be linked to several risk factors in our population of school children. Many environmental factors might be incriminated in these allergic diseases.
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Affiliation(s)
- Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- *Souheil Hallit, Street 8, Building 560, 1st floor, Biakout (Lebanon), E-Mail
| | - Chantal Raherison
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France
- Department of Pneumology, University Hospital, Bordeaux, France
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
| | - Nelly Kheir
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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15
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Layoun N, Hallit S, Waked M, Aoun Bacha Z, Godin I, Leveque A, Dramaix M, Salameh P. Predictors of past quit attempts and duration of abstinence among cigarette smokers. J Epidemiol Glob Health 2017; 7:199-206. [PMID: 28756830 PMCID: PMC7320454 DOI: 10.1016/j.jegh.2017.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/29/2017] [Accepted: 06/28/2017] [Indexed: 01/29/2023] Open
Abstract
Objective: Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers. Methods: This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results: Smokers who have chronic allergies (ORa = 2.45, p = 0.03), those who have ever stopped smoking for at least one month due to the warnings implemented on the packages (ORa = 4.6, p < 0.0001) and smokers with an intention to quit in 2 months (ORa = 2.49, p < 0.0001) had significantly more past quit attempts. Results: Furthermore, longer quit attempts duration (more than 1 month) were significantly associated with low-nicotine dependent smokers (ORa = 0.56, p = 0.02), higher-motivated smokers (ORa = 1.85, p = 0.01), people with chronic allergies (ORa = 2.07, p = 0.02), smokers who have ever stopped smoking for at least one month due to the warnings (ORa = 3.72, p < 0.0001) and those with an intention to quit in 2 months (ORa = 1.98, p = 0.05). Conclusion: The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning.
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Affiliation(s)
- N Layoun
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium; Doctoral School of Sciences and Technologies, Lebanese University, Beirut, Lebanon; Lebanese University, Faculty of Pharmacy, Beirut, Lebanon.
| | - S Hallit
- Lebanese University, Faculty of Pharmacy, Beirut, Lebanon; Saint-Joseph University, Faculty of Pharmacy, Beirut, Lebanon; Holy Spirit University of Kaslik, Faculty of Medicine and Medical Sciences, Kaslik, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, France; Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
| | - M Waked
- Department of Pulmonology, St George Hospital University Medical Center, Faculty of Medicine, Balamand University, Lebanon
| | - Z Aoun Bacha
- Department of Pulmonary and Critical Care Medicine, Hotel-Dieu de France, Beirut, Lebanon
| | - I Godin
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium
| | - A Leveque
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium
| | - M Dramaix
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium
| | - P Salameh
- Lebanese University, Faculty of Pharmacy, Beirut, Lebanon; Lebanese University, Faculty of Medicine, Beirut, Lebanon
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