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Helou M, Mouawad Y, El Ters F, Husni R. Measles Outbreak in Lebanon: July 2023. Disaster Med Public Health Prep 2024; 18:e49. [PMID: 38525826 DOI: 10.1017/dmp.2024.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
After the beginning of the Syrian crisis, increased rates of infectious diseases were reported. Lebanon, a neighboring country with a major socioeconomic crisis, witnessed a measles outbreak since July 2023, with 519 reported suspected cases. Half of the cases were under 5 y of age, most of them were unvaccinated. The mass displacement of refugees from conflict areas in Syria to Lebanon and the low vaccination coverage have made the situation more challenging. Further efforts are required in Lebanon to address identified gaps to prevent or at least better control future outbreaks.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Yara Mouawad
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Fadi El Ters
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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Helou M, Nasr J, Hajjar M, Bourji A, Feghaly R, Jabbour E, Abboud E, Abboud E, Mahdi A, Mina J, Asmar A, Husni R. Epidemiology of pathogens causing acute diarrhea in patients presenting to the emergency departments in 4 hospitals in Lebanon. Medicine (Baltimore) 2024; 103:e37316. [PMID: 38428867 PMCID: PMC10906651 DOI: 10.1097/md.0000000000037316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
Acute diarrhea is a prevalent disease worldwide and a cause of mortality in low and middle-income countries. In previous studies, the causative enteropathogen is found in 38% to 58% of patients, leaving a considerable diagnostic gap. In this study, we intend to determine the pathogenic agents responsible for acute diarrhea in patients presenting to the Emergency Departments of several Lebanese hospitals. A total of 100 stool samples were collected between June 2022 and June 2023 from patients presenting with acute diarrhea to the Emergency Departments. Pathogens were detected by multiplex polymerase chain reaction. The average age for the patients was 53 years old. All patients presented with diarrhea, 15 of them had fever associated. In total, 46 patients were admitted to the hospital (70%), among them 80% received Intravenous antibiotics. Campylobacter was the most common agent detected in 36%, followed by Rotavirus 19%, and Noroviruses 15%. The rest was detected at lower percentages. Bacteria accounted for 49% of cases, viruses for 39%, and parasitic infection 6%. Acute diarrhea epidemiology is understudied in Lebanon. This study is the first Lebanese data about acute diarrhea pathogens. Avoiding overuse of antibiotics in bacterial versus viral infections can be achieved while prevention campaigns can raise awareness about food and water safety at the community level.
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Affiliation(s)
- Mariana Helou
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Janane Nasr
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | | | - Alaa Bourji
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rita Feghaly
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Elsy Jabbour
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Edmond Abboud
- Laboratory Department, The Middle East Institute of Health University Hospital, Mount Lebanon, Lebanon
| | - Emma Abboud
- Laboratory department, Mount Liban Hospital, Lebanon
| | - Ahmad Mahdi
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY
| | - Alain Asmar
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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3
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Farhat H, Alinier G, Helou M, Galatis I, Bajow N, Jose D, Jouini S, Sezigen S, Hafi S, Mccabe S, Somrani N, Aifa KE, Chebbi H, Amor AB, Kerkeni Y, Al-Wathinani AM, Abdulla NM, Jairoun AA, Morris B, Castle N, Al-Sheikh L, Abougalala W, Dhiab MB, Laughton J. Perspectives on Preparedness for Chemical, Biological, Radiological, and Nuclear Threats in the Middle East and North Africa Region: Application of Artificial Intelligence Techniques. Health Secur 2024. [PMID: 38335443 DOI: 10.1089/hs.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Over the past 3 decades, the diversity of ethnic, religious, and political backgrounds worldwide, particularly in countries of the Middle East and North Africa (MENA), has led to an increase in the number of intercountry conflicts and terrorist attacks, sometimes involving chemical and biological agents. This warrants moving toward a collaborative approach to strengthening preparedness in the region. In disaster medicine, artificial intelligence techniques have been increasingly utilized to allow a thorough analysis by revealing unseen patterns. In this study, the authors used text mining and machine learning techniques to analyze open-ended feedback from multidisciplinary experts in disaster medicine regarding the MENA region's preparedness for chemical, biological, radiological, and nuclear (CBRN) risks. Open-ended feedback from 29 international experts in disaster medicine, selected based on their organizational roles and contributions to the academic field, was collected using a modified interview method between October and December 2022. Machine learning clustering algorithms, natural language processing, and sentiment analysis were used to analyze the data gathered using R language accessed through the RStudio environment. Findings revealed negative and fearful sentiments about a lack of accessibility to preparedness information, as well as positive sentiments toward CBRN preparedness concepts raised by the modified interview method. The artificial intelligence analysis techniques revealed a common consensus among experts about the importance of having accessible and effective plans and improved health sector preparedness in MENA, especially for potential chemical and biological incidents. Findings from this study can inform policymakers in the region to converge their efforts to build collaborative initiatives to strengthen CBRN preparedness capabilities in the healthcare sector.
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Affiliation(s)
- Hassan Farhat
- Hassan Farhat, MRes, MSc, is a Quality Improvement Mentor, Quality Patient Safety and Risk Management, Ambulance Service Group, Hamad Medical Corporation, Doha, Qatar; PhD Candidate, Faculty of Medicine "Ibn El Jazzar," University of Sousse, Sousse, Tunisia; and PhD Candidate, Faculty of Sciences, University of Sfax, Sfax, Tunisia, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Guillaume Alinier
- Guillaume Alinier, PhD, MPhys (Hons), PGCert, SFHEA, NTF, is Director of Research, Ambulance Service, Hamad Medical Corporation, Doha, Qatar; Visiting Professor, School of Health and Social Work, University of Hertfordshire, Hatfield, UK; Adjunct Professor, Weill Cornell Medicine-Qatar, Doha, Qatar; and Visiting Professor, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Mariana Helou
- Mariana Helou, MD, MSc DM, is a Clinical Assistant Professor and Clerkship Director of Emergency Room, Division Head of Emergency Medicine, Internal Medicine Department - Emergency, Medicine Gilbert and Rose-Marie Chagoury School of Medicine, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Ionnais Galatis
- Ionnais Galatis, Brigadier General (ret.), MD, MSc, MC, is an MD Consultant in Allergy & Clinical Immunology, Medical/Hospital/Ops CBRNE Planner/Instructor, Senior Asymmetric Threats Analyst, and Research Associate, Center for Security Studies (KEMEA), Athens, Greece; Manager, CBRN Knowledge Center, International CBRNE Institute, Brussels, Belgium; and Senior Advisor, Research Institute for European and American Studies, Alimos, Greece, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Nidaa Bajow
- Nidaa Bajow, MD, PhD, is Disaster Medicine Coordinator and Disaster Medicine Training Supervisor, Disaster Medicine Unit, Emergency Department Security Force Hospital Riyadh, Saudi Arabia, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Denis Jose
- Denis Jose, Pharm D, PhD, is Colonel, Head, Pharmaceutical Services, and Technical Adviser on Toxicological and CBRNE Risk Management, Alpes-Maritimes Fire and Rescue Services, Paris, France, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Sarra Jouini
- Sarra Jouini, MD, is Emergency Coordinator, Emergency Department, Charles Nicolle Hospital, and an Associate Professor, EL Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Sermet Sezigen
- Sermet Sezigen, MD, PhD, is an Associate Professor, Department of Medical CBRN Defense, University of Health Sciences, Ankara, Turkey, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Samia Hafi
- Samia Hafi, MD, is Head of SAMU(EMS), Hospital of Gabes, Gabes, Tunisia, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Sheena Mccabe
- Sheena Mccabe, MSc, is a Consultant Lecture for BSc in Crisis and Emergency Management, Ras Laffan Emergency and Safety College, Ras Laffan, Qatar, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Naoufel Somrani
- Naoufel Somrani, MD, is General Director of Public Health Facilities, Ministry of Health, Tunis, Tunisia, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Kawther El Aifa
- Kawther El Aifa, MSc, is a Quality Management/Improvement Reviewer, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Henda Chebbi
- Henda Chebbi, MD, is Assistant Director of Emergency Medicine Unit, Strategic Health Operations Center (SHOCR Room), Emergency Medicine Directorate, Ministry of Health, Tunis, Tunisia, at King Saud University, Riyadh, Saudi Arabia
| | - Asma Ben Amor
- Asma Ben Amor, MRes, is a Paramedicine Professor, Higher School of Health Sciences and Technologies of Sousse, and a PhD Candidate, Faculty of Medicine "Ibn El Jazzar," University of Sousse, Sousse, Tunisia, at King Saud University, Riyadh, Saudi Arabia
| | - Yosra Kerkeni
- Yosra Kerkeni, MD, is Emergency Coordinator, Emergency Medicine, Ministry of Health, Tunis, Tunisia, at King Saud University, Riyadh, Saudi Arabia
| | - Ahmed M Al-Wathinani
- Ahmed M. Al-Wathinani, MHA, PhD, is Vice Dean of Academic Affairs, College of Applied, Business Administration; Chairman of the Emergency Medical Services Department; Associate Professor of Emergency and Disaster Management, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, at King Saud University, Riyadh, Saudi Arabia
| | - Nassem Mohammed Abdulla
- Nassem Mohammed Abdulla, PhD, is Head of Department, Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates, in Doha, Qatar
| | - Ammar Abdulrahman Jairoun
- Ammar Abdulrahman Jairoun, PhD, is Senior Consumables Material Inspection Officer, Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates; and Head of Department, Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia, in Doha, Qatar
| | - Brendon Morris
- Brendon Morris, MRes, MTec, is Executive Director, Major Incident Planning and Resilience, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Nicholas Castle
- Nicholas Castle, PhD FIMC, is Interim Executive Director, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Loua Al-Sheikh
- Loua Al-Sheikh, MBChB, BSc(Hons), FRCA, is Medical Director, The Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Walid Abougalala
- Walid Abougalala, MBBS, EMDM, JMC(EM), MSc, MAo, MEdu, is a Consultant Emergency Preparedness and Response Department, Ministry of Public Health; Chairman, Corporate Facility Management and Safety Committee; and Consultant Emergency and Disaster Medicine, Hamad Medical Corporation, in Doha, Qatar
| | - Mohamed Ben Dhiab
- Mohamed Ben Dhiab, MD, is Vice Dean, Academic Affairs, Faculty of Medicine "Ibn El Jazzar," University of Sousse, and Professor of Forensic and Legal Medicine, Farhat Hached Academic Hospital, Sousse, Tunisia
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4
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Yammine K, Abdallah R, Stiban S, Helou M, Hayek F, Assi C. Monitoring negative pressure wound therapy for diabetic foot ulcers using WhatsApp. J Tissue Viability 2024; 33:1-4. [PMID: 38220561 DOI: 10.1016/j.jtv.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
Foot complications of patients with diabetes could lead to amputations and early death. Diabetic foot ulcers (DFU) are usually difficult to treat and impose huge financial burden. Monitoring wound progress is the mainstay of any treatment and alternatives to face-to-face consultations such as tele-medicine have been proposed. Very few papers explored the utility and effectiveness of monitoring DFU through instant messaging application such as WhatsApp. The aim of this study is to evaluate the validity of WhatsApp in monitoring diabetic wounds treated with negative pressure wound therapy (NPWT). Twenty-two patients were prospectively recruited. All patients had an initial face-to-face consultation and debridement. Dressings were changed twice per week at patient's residence and media files were sent by the wound nurse via Short Message Service (SMS). A subsequent face to face consultation was scheduled whenever a complication was suspected. The primary outcomes were the percentages of accurate cases a) where a new or recurrent infection was suspected, and a b) where a debridement was thought to be needed. Complete healing of the defect using NPWT was achieved in 10 patients and a skin graft procedure was needed in another 4 patients. Five patients needed further surgical debridement. Failure to heal was observed in 3 patients. Out of the seven cases where a new infection was suspected, five (71.5%) were confirmed on face-to-face consultation. No confirmed cases of infection were observed during follow-up for those estimated as clean. Out of the 11 cases where debridement was favored based on WhatsApp media files, confirmation of a needed debridement was recorded in 8 (73%) cases. NPWT monitoring of for diabetic foot and leg ulcers using WhatsApp application was found to be an excellent method to document and track the wound process and complications. The excellent specificity and high sensibility should encourage for common use by healthcare. The results of this study could be also valuable for patients living in rural areas and in case of future pandemics.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon; Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
| | - Ralph Abdallah
- Faculty of Arts and Science, University of Toronto, Canada
| | - Sonia Stiban
- Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
| | - Fady Hayek
- Division Vascular Surgery, Department General Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
| | - Chahine Assi
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
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Helou M, Mahdi A, Fayad AA, Sleiman A, Matar GM, Zoghbi S, Madani T, Husni R. Author Correction: Antimicrobial effects of chlorine dioxide in a hospital setting. Sci Rep 2024; 14:2475. [PMID: 38291233 PMCID: PMC10828396 DOI: 10.1038/s41598-024-53034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Ahmad Mahdi
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Antoine Abou Fayad
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ahmad Sleiman
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ghassan M Matar
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sanaa Zoghbi
- Infection Control Program, Lebanese American University Medical Center, Beirut, Lebanon
| | - Tarek Madani
- Infection Control Program, Lebanese American University Medical Center, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon.
- Lebanese American University-Rizk Hospital, Beirut, Lebanon.
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Helou M, Mahdi A, Abou Fayad A, Sleiman A, Matar GM, Zoghbi S, Madani T, Husni R. Antimicrobial effects of chlorine dioxide in a hospital setting. Sci Rep 2023; 13:22866. [PMID: 38129523 PMCID: PMC10739700 DOI: 10.1038/s41598-023-49997-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Chlorine dioxide is a powerful disinfectant with strong antibacterial properties. We conducted a study at different sites of the Lebanese American University Medical Center-Rizk Hospital to determine the efficacy of the ECOM air mask in decreasing the particle load. Air cultures were obtained from three different locations, namely the patients' elevator, visitors' elevator and mobile clinic and the number of colonies grown on each type of agar was determined. We also measured particle counts at the three sites both at baseline and after placement of the ECOM air mask. After 7 days of ECOM air mask use, the numbers of colonies grown on all types of media was decreased by 20-100% versus the baseline values. The counts of particles of different diameters (0.3, 0.5 and 5 µm) were decreased at all three sampled sites. This study highlighted the efficacy of the ECOM air mask. The utility of the gaseous form of ClO2 as an antiseptic in the hospital setting appears promising.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Ahmad Mahdi
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Antoine Abou Fayad
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ahmad Sleiman
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ghassan M Matar
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sanaa Zoghbi
- Infection Control Program, Lebanese American University Medical Center, Beirut, Lebanon
| | - Tarek Madani
- Infection Control Program, Lebanese American University Medical Center, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon.
- Lebanese American University-Rizk Hospital, Beirut, Lebanon.
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Weinstein E, Cuthbertson J, Herbert TL, Bortolin M, Magalini S, Gui D, Helou M, Faccincani R, Ragazzoni L, Caviglia M. The Advancement of the Scientific Study of Prehospital MCI Response from TIIDE to NIGHTINGALE: A Scoping Review - CORRIGENDUM. Prehosp Disaster Med 2023; 38:550. [PMID: 37485685 DOI: 10.1017/s1049023x23006106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
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8
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Weinstein ES, Cuthbertson JL, Herbert TL, Voicescu GT, Bortolin M, Magalini S, Gui D, Helou M, Lennquist Montan K, Montan C, Rafalowsky C, Ratto G, Damele S, Bazurro S, Laist I, Marzi F, Borrello A, Fransvea P, Fidanzio A, Benitez CY, Faccincani R, Ragazzoni L, Caviglia M. Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage. Eur J Trauma Emerg Surg 2023; 49:1647-1660. [PMID: 37060443 PMCID: PMC10449715 DOI: 10.1007/s00068-023-02266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/26/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements. METHODS The authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes. RESULTS The initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study. CONCLUSION The three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study.
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Affiliation(s)
- Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy.
| | - Joseph L Cuthbertson
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Teri Lynn Herbert
- Research and Education Services, Medical University of South Carolina Library, Charleston, SC, USA
| | - George T Voicescu
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Michelangelo Bortolin
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Sabina Magalini
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniele Gui
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariana Helou
- School of Medicine, Department of Emergency Medicine, Lebanese American University, Beirut, Lebanon
| | - Kristina Lennquist Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Carl Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Chaim Rafalowsky
- Magen David Adom, National Emergency Medical, Disaster, Ambulance and Blood Bank Service, Ashkelon, Israel
| | - Giuseppe Ratto
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Stefano Damele
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Simone Bazurro
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Itamar Laist
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Federica Marzi
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Borrello
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Fransvea
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Andrea Fidanzio
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlos Yanez Benitez
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Roberto Faccincani
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Luca Ragazzoni
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Marta Caviglia
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Haykal T, Mina J, Fleifel M, Dimassi H, Nasr J, Mahdi A, Harb R, El Hout G, Franjieh E, Mokhbat J, Farra A, Helou M, Husni R. Evolution of COVID-19 infection characteristics in a Lebanese cohort of inpatients during different pandemic periods. Pathog Glob Health 2023:1-10. [PMID: 37482700 DOI: 10.1080/20477724.2023.2239492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
This study aims to describe COVID-19 patients characteristics, laboratory and imaging results, and the different outcomes of patients admitted to the Lebanese American University Medical Center-Rizk Hospital over a period of 9 months. In this observational retrospective study, data were obtained from electronic medical records of 491 male and female patients from the ages of 17 to 97. Analysis of the patients was performed in 3 periods: August 2020 to October 20 November 202020 to January 2021 and February 2021 to April 2021 corresponding with 3 waves of newly diagnosed cases during this period. The sample showed a male predominance with an average age of 63. The average hospitalization length was 10.1 days. The majority of patients were discharged to quarantine. The distribution of hospitalized cases was significantly correlated to the monthly distribution of newly COVID-19 cases in Lebanon. There was no significant difference in patient's characteristics between the 3 periods of the study (gender, age, body mass index, smoking, and medical conditions). Clinical presentations of the patients varied between the 3 periods. Similarly, the course and outcome of infection varied. Patients received less oxygen during period 1, while more patients were cured during period 3. This study presents the first Lebanese cohort of COVID-19 patients with their medical background, clinical presentation, laboratory results, radiological findings and course of infection with its outcome. It also shows how the relations between the medical manifestation of the COVID-19 pandemic and the socio-political measures of infection control are deeply intertwined.
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Affiliation(s)
- Tony Haykal
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Jonathan Mina
- Department of Internal Medicine, Staten Island University Hospital, New York, USA
| | - Mohamad Fleifel
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Hani Dimassi
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Janane Nasr
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Ahmad Mahdi
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Ranime Harb
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Ghida El Hout
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Elissar Franjieh
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Jacques Mokhbat
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Anna Farra
- Department of Internal Medicine, Lebanese American University Medical Centre-Rizk Hospital, Beirut, Lebanon
| | - Mariana Helou
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Rola Husni
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
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Helou M, Khalil M, Husni R. The Cholera Outbreak in Lebanon: October 2022 - CORRIGENDUM. Disaster Med Public Health Prep 2023; 17:e431. [PMID: 37462342 DOI: 10.1017/dmp.2023.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
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Moghnieh R, Husni R, Helou M, Abdallah D, Sinno L, Jadayel M, Diab K, Chami C, Al Rachid M, Awad DC, Zaiter A, Sayegh MH. The Prevalence and Risk Factors of Acute Kidney Injury during Colistin Therapy: A Retrospective Cohort Study from Lebanon. Antibiotics (Basel) 2023; 12:1183. [PMID: 37508279 PMCID: PMC10376607 DOI: 10.3390/antibiotics12071183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/08/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION The current study aimed to determine the prevalence, risk factors, and stages of severity of acute kidney injury (AKI) caused by colistimethate sodium (CMS) treatment in patients diagnosed with systemic antibiotic-resistant Gram-negative bacterial infections. The predictors of all-cause mortality in this patient population were also examined. METHODS This retrospective cohort study included patients who were admitted to a university-affiliated hospital and acute tertiary care referral center in Beirut, Lebanon between January 2015 and December 2018 and underwent CMS treatment for a period of 48 h or more. RESULTS The study sample included 298 adult patients, of which 46.3% (n = 138/298) developed AKI (assessed using the Kidney Disease Improving Global Outcomes (KDIGO) criteria). Of these, 37.7% (n = 51/138) were diagnosed with stage 1 AKI, 23.9% with stage 2 (n = 33/138), and 38.4% with stage 3 (n = 53/138). Nephrotoxicity was reversed in 87.5% of AKI patients who survived until hospital discharge. Independent risk factors for AKI included patient age ≥ 75 years (aOR = 1.854; 95% CI: 1.060-3.241; p-value = 0.03); underlying chronic kidney disease (aOR = 4.849; 95% CI: 2.618-9.264; p-value < 0.0001); and concomitant use of vasopressors (aOR = 4.305; 95% CI: 2.517-7.456; p-value < 0.0001). Multivariate analysis showed that the predictors of severe AKI (stage 2 or 3) included baseline hypoalbuminemia (aOR = 2.542; 95% CI: 1.000-6.564; p-value = 0.05); concomitant use of vasopressors (aOR = 6.396; 95% CI: 2.741-15.87; p-value < 0.0001); and CMS days of therapy (DOT) prior to development of AKI ≥ 7 days (aOR = 4.728; 95% CI: 2.069-11.60; p-value < 0.0001). All-cause mortality was recorded in 51.3% of patients (n = 153/298), and this was significantly higher in patients with AKI (76.8%; n = 106/138) compared to those without (29.4%; n = 47/160; OR = 7.964; 95% CI: 4.727-13.417; p-value < 0.0001). Independent predictors of all-cause mortality included a baseline Charlson comorbidity index score ≥5 (aOR = 4.514; 95% CI: 2.443-8.530; p-value < 0.0001); concomitant use of vasopressors (aOR = 7.76; 95% CI: 4.238-14.56; p-value < 0.0001); and CMS-induced AKI (aOR = 4.117; 95% CI: 2.231-7.695; p-value < 0.0001). CONCLUSIONS The findings of this study suggest that old age, history of chronic kidney disease, and concomitant vasopressor treatment are all independent predictors of CMS-induced AKI. The risk of developing severe AKI significantly increases with CMS DOT. Understanding the risk factors of nephrotoxicity is essential for improving prognosis and treatment outcomes.
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Affiliation(s)
- Rima Moghnieh
- Department of Internal Medicine, Lebanese American University Medical Center, 13-5053 Beirut, Lebanon
- Department of Internal Medicine, Division of Infectious Diseases, Makassed General Hospital, 11-6301 Beirut, Lebanon
| | - Rola Husni
- Department of Internal Medicine, Lebanese American University Medical Center, 13-5053 Beirut, Lebanon
| | - Mariana Helou
- Department of Internal Medicine, Lebanese American University Medical Center, 13-5053 Beirut, Lebanon
| | - Dania Abdallah
- Pharmacy Department, Makassed General Hospital, 11-6301 Beirut, Lebanon
| | - Loubna Sinno
- Department of Medical Research, Makassed General Hospital, 11-6301 Beirut, Lebanon
| | - Marwa Jadayel
- Faculty of Pharmacy, Lebanese University, 6573/14 Beirut, Lebanon
| | - Kawsar Diab
- Department of Obstetrics and Gynecology, Al-Zahraa Hospital-University Medical Center, VF7P+JVR Beirut, Lebanon
- Faculty of Medicine, Lebanese University, 6573/14 Beirut, Lebanon
| | - Carmen Chami
- Faculty of Medicine, Lebanese University, 6573/14 Beirut, Lebanon
| | - Marah Al Rachid
- Faculty of Medicine, Lebanese University, 6573/14 Beirut, Lebanon
| | | | - Aline Zaiter
- Faculty of Medicine, Lebanese University, 6573/14 Beirut, Lebanon
| | - Mohamed H Sayegh
- Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon
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Helou M, Zoghbi S, El Osta N, Mina J, Mokhbat J, Husni R. COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study. Medicine (Baltimore) 2023; 102:e32992. [PMID: 37115042 PMCID: PMC10143398 DOI: 10.1097/md.0000000000032992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Sanaa Zoghbi
- Division of Infection Control, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jacques Mokhbat
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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Helou M, Nasr J, El Osta N, Jabbour E, Husni R. Liver manifestations in COVID-19 patients: A review article. World J Clin Cases 2023; 11:2189-2200. [PMID: 37122526 PMCID: PMC10131011 DOI: 10.12998/wjcc.v11.i10.2189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/09/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) initially presented as a disease that affected the lungs. Then, studies revealed that it intricately affected disparate organs in the human body, with the liver being one of the most affected organs. This review aimed to assess the association between COVID-19 and liver function, shedding light on its clinical implication. However, its exact pathophysiology remains unclear, involving many factors, such as active viral replication in the liver cells, direct cytotoxic effects of the virus on the liver or adverse reactions to viral antigens. Liver symptoms are mild-to-moderate transaminase elevation. In some patients, with underlying liver disease, more serious outcomes are observed. Thus, liver function should be meticulously considered in patients with COVID-19.
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Affiliation(s)
- Mariana Helou
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University Medical Center, Lebanese American University School of Medicine, Beirut 1102-2801, Lebanon
| | - Janane Nasr
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Elsy Jabbour
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
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Husni R, Bou Zerdan M, Samaha N, Helou M, Mahfouz Y, Saniour R, Hourani S, Kolanjian H, Afif C, Azar E, El Jisr T, Mokhbat J, Abboud E, Feghali R, Abboud E, Matta H, Karayakouboglo G, Matar M, Moghnieh R, Daoud Z. Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese hospitals. Front Public Health 2023; 11:1115055. [PMID: 36969669 PMCID: PMC10036786 DOI: 10.3389/fpubh.2023.1115055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundInvasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is Candida albicans with little emphasis placed on non-albicans Candida species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans Candida species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.MethodsThis is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.ResultsOut of the 1000 collected isolates, Candida glabrata, being the most isolated species (40.8%), followed by Candida tropicalis: 231(23.1%), Candida parapsilosis: 103(10.3%), and other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.ConclusionThe change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.
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Affiliation(s)
- Rola Husni
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
- *Correspondence: Rola Husni
| | - Maroun Bou Zerdan
- Department of Internal Medicine, SUNY Upstate Medical University Hospital, Syracuse, NY, United States
| | - Nadia Samaha
- Georgetown University School of Medicine, Washington, DC, United States
| | - Mariana Helou
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Youssef Mahfouz
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Rim Saniour
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Sawsan Hourani
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Harout Kolanjian
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Claude Afif
- Department of Internal Medicine, Saint George Hospital-University Medical Center, Beirut, Lebanon
| | - Eid Azar
- Department of Internal Medicine, Saint George Hospital-University Medical Center, Beirut, Lebanon
| | - Tamima El Jisr
- Department of Laboratory, Makased General Hospital, Beirut, Lebanon
| | - Jacques Mokhbat
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Emma Abboud
- Department of Laboratory, Mount Liban Hospital, Hazmiyeh, Lebanon
| | - Rita Feghali
- Department of Laboratory, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Edmond Abboud
- Department of Laboratory, The Middle East Institute of Health University Hospital, Mount Lebanon, Lebanon
| | - Hiam Matta
- Saint Georges Ajaltoun Hospital, Ajaltoun, Lebanon
| | | | - Madonna Matar
- Department of Internal Medicine, Notre Dame de Secours University Hospital, Byblos, Lebanon
| | - Rima Moghnieh
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Ziad Daoud
- College of Medicine, Central Michigan University, Saginaw, MI, United States
- Department of Clinical Microbiology and Infection Prevention, Michigan Health Clinics, Saginaw, MI, United States
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Sakr R, Helou M, Hamieh C, Estephan M, Chrabieh R, Salameh P, Khazen G, Kolanjian H, Jabbour E, Husni R. Perception of the Lebanese Adults about Vaccination: A Survey. Vaccines (Basel) 2023; 11:vaccines11030621. [PMID: 36992205 DOI: 10.3390/vaccines11030621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction: With the continuous spread and emergence of transmissible diseases, focusing on preventive measures is essential to decrease their incidence and spread. In addition to behavioral measures, vaccination is an optimal way to protect the population and eradicate infectious diseases. The majority are aware of children’s vaccinations, while many might not know that adult vaccinations are also essential. Objectives: This study aims to understand the perception of Lebanese adults towards vaccination and their knowledge and awareness of its importance. This is a national cross-sectional study, conducted between January 2020 and January 2021. Results: the data were collected from 1023 subjects, the majority being Lebanese, previously healthy, and with a graduate or post-graduate level of education. Out of these participants, 44.9% were advised to take vaccines, half of them by healthcare workers. The most common vaccine received during adult life is the Flu vaccine. Overall, 25.6% of the participants were unaware that they needed vaccines and 27.9% thought it is not indicated. Participants’ knowledge about vaccination is variable. In total, 39.4% agree or are uncertain whether vaccines contain harmful chemicals and 48.4% believe that vaccines will trigger diseases. The level of education and occupation significantly enhances knowledge about vaccination. Some participants 27.3% are concerned about the vaccine’s side effects. The group of young participants, graduates, and nonsmokers think that the vaccine is a necessity and had a positive attitude towards vaccination. Conclusions: Many Lebanese lack knowledge about adult vaccination protection and its benefits in the community. It is essential that the country’s health ministry department collaborate with the healthcare system to launch awareness campaigns about adult vaccination in the country to overcome the barriers and ensure better coverage.
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Affiliation(s)
- Rania Sakr
- Lebanese American University Medical Center Rizk Hospital, Division of Family Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Mariana Helou
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Cima Hamieh
- Lebanese American University Medical Center Rizk Hospital, Division of Family Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Michelle Estephan
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Remie Chrabieh
- Department of Dermatology, Lebanese American University Medical Center Rizk Hospital, Beirut 1102 2801, Lebanon
| | - Pascale Salameh
- Faculty of Medicine, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Georges Khazen
- Computer Science and Mathematics Department, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Harout Kolanjian
- Faculty of Medicine, Lebanese American University, Beirut 1102 2801, Lebanon
| | - Elsy Jabbour
- Lebanese American University Medical Center Rizk Hospital, Division of Emergency Medicine, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
| | - Rola Husni
- Lebanese American University Medical Center Rizk Hospital, Division of Infectious Diseases, Lebanese American University School of Medicine, Beirut 1102 2801, Lebanon
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Daou R, Khater DA, Khattar R, Helou M. Aortic dissection presenting as a stroke: a case report. Pan Afr Med J 2023; 44:91. [PMID: 37229301 PMCID: PMC10204108 DOI: 10.11604/pamj.2023.44.91.38533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/02/2023] [Indexed: 05/27/2023] Open
Abstract
Aortic dissection is an uncommon yet frequently fatal illness. Patients generally present with tearing chest pain with possible acute hemodynamic instability. Hence, early diagnosis and intervention is critical for survival. This is a case of a 62-year-old male who was transferred to our emergency department for severe chest pain, left side hemiplegia, left hemianopsia, left facial weakness, suggesting a right-sided stroke. A chest computed tomography angiogram showed an extensive circumferential aortic dissection of the intimal layer involving the great vessels. Antiplatelet medications were withheld, nicardipine was started, and the cardiothoracic surgeon was consulted. There was no indication for surgery, and patient was admitted to the intensive care unit. We highlight here the importance of considering an aortic dissection in patients who present with neurological symptoms and an acute history of tearing chest pain.
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Affiliation(s)
- Rafi Daou
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Danielle Abou Khater
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rita Khattar
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
- Lebanese American University, School of Medicine, Beirut, Lebanon
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Yammine K, Daher J, Otayek J, Jardaly A, Mansour J, Boulos K, Alam AE, Ghanimeh J, Abou Orm G, Berberi M, Daccache E, Helou M, Estephan M, Assi C, Hayek F. Beirut massive blast explosion: A unique injury pattern of the wounded population. Injury 2023; 54:448-452. [PMID: 36414502 DOI: 10.1016/j.injury.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 10/04/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION On August 4, 2020, a massive explosion of a warehouse holding 2,700 metric tons of ammonium nitrate took place in the port of Beirut, Lebanon. This incident, which is considered as one of the largest industrial disasters lead to the death of at least 220 people and more than 6000 injuries. Hospitals near the blast were damaged significantly which made it difficult to treat injured patients. The objective of this study is to report the epidemiology and characteristics of the injuries and their initial management that could be useful for healthcare workers and policymakers in case of a similar massive accident in the future. MATERIALS AND METHODS A retrospective study was conducted. All charts of patients admitted to the emergency room and outpatient clinics on the day of the blast and during the following 2 weeks were thoroughly reviewed. Due to initial chaos during triage, direct phone contact with patients was utilized in certain situations to confirm their identity or for further information. All acute injuries were recorded based on the region, severity, degree of emergency, initial and later management, type of injured organs, and surgical procedures. RESULTS A total of 159 patients presented to our facility. 153 patients presented to the ER on the same day of the blast. The mean age was 47.07 years and around 60% of the patients were males (n = 93). Most of the patients presented either from zone 1 (n = 67, 42%) or zone 3 (n = 68, 43%). The majority of injuries were secondary injuries due to glass (n = 131, 82.3%), with the head (34%) and upper extremities (31.2%) being most commonly affected. A total of 94 patients (62.6%) underwent a type of imaging and 64 patients (40.2%) had at least one surgery performed during their hospitalization in which 71% of the surgeries being related to the limbs. CONCLUSION This study demonstrated a unique injury pattern due to this type of blast. Injuries were mostly due to glass shrapnel. Contrary to bomb blasts, most injuries were located in the head and upper extremities rather than on the lower extremities.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon.
| | - Jimmy Daher
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Joeffroy Otayek
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Achraf Jardaly
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Jad Mansour
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Karl Boulos
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Anthony El Alam
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Joe Ghanimeh
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Ghady Abou Orm
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Mary Berberi
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Elio Daccache
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Michel Estephan
- Department of Emergency Medicine, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Chahine Assi
- Department of Orthopedic and Trauma Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
| | - Fady Hayek
- Division of Vascular Surgery, Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, Lebanese American School of Medicine, Beirut, Lebanon
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Helou M, El Osta N, Husni R. Impact of the COVID-19 pandemic on healthcare workers’ families. World J Clin Cases 2022; 10:9964-9966. [PMID: 36186190 PMCID: PMC9516914 DOI: 10.12998/wjcc.v10.i27.9964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023] Open
Abstract
The coronavirus disease 2019 pandemic had a significant effect on the mental health, social lives, and family relationships of healthcare workers. During the pandemic, these workers had to prioritize their work over parenting, spending time with their kids or partners, planning weddings, and childbearing plans. Therefore, special recognition should be given to the families of these employees.
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Affiliation(s)
- Mariana Helou
- Department of Emergency Medicine, Lebanese American University school of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
| | - Nour El Osta
- Department of Emergency, Lebanese American University School of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
| | - Rola Husni
- Department of Infectious Diseases, Lebanese American University School of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
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Abstract
On August 4, 2020, a major explosion took place in Beirut, the capital of Lebanon. Some hospitals in Beirut were destroyed and became nonfunctional, and others were overwhelmed with casualties, with 8643 casualties admitted to emergency departments on that night. The Lebanese American University Medical Center-Rizk Hospital, 2.8 km away from the blast, received an unexpected number of casualties. While a disaster plan was conceived earlier, this hospital's emergency department faced many challenges on that night, and major flaws in their preparedness plan were seen.
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Affiliation(s)
- Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
| | - Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Universita del Piemonte Orientale, Novara, Italy
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El Tawil C, El Hussein M, Souaiby N, Helou M. Emergency Department Management of COVID-19 Suspected Patients. An International Perspective. Int J Public Health 2022; 67:1604534. [PMID: 35574275 PMCID: PMC9098677 DOI: 10.3389/ijph.2022.1604534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Objectives: In December 2019, an invasive viral outbreak, the Corona Virus Disease 19 spread to the whole world. An international cross-sectional study was conducted to evaluate how healthcare workers in Emergency departments dealt with this pandemic. Methods: A questionnaire was sent to 180 healthcare workers around the world during May and June of the year 2020. Results: A total of 134 HCW from 23 countries responded with a majority of Emergency physicians (36.8%). The PCR testing is available in 72.9% of the hospitals. Different architectural strategies were used to isolate suspected cases in the Emergency department (ED). Half of the institutions would not allow visitors, while the other half, restricted visiting hours and the number of visitors. Triage for suspected patients relied in 82.8% on symptoms. Almost 98% of HCW used a combination of mask, gloves, gown and face shield. Around 65% of the HCW have a tendency to discharge more patients from the ED than what they were used to. Conclusion: The COVID-19 pandemic made a major change within the emergency departments worldwide.
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Affiliation(s)
| | - Mahmoud El Hussein
- Gilbert and Rose-Mary Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | | | - Mariana Helou
- Gilbert and Rose-Mary Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
- *Correspondence: Mariana Helou,
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El Khoury J, Hlais S, Helou M, Mouhawej MC, Barmo S, Fadel P, Tohme A. Evaluation of efficacy and safety of subcutaneous acetaminophen in geriatrics and palliative care (APAPSUBQ). BMC Palliat Care 2022; 21:42. [PMID: 35346136 PMCID: PMC8961903 DOI: 10.1186/s12904-022-00934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Subcutaneous infusion (SC) or hypodermoclysis is an old perfusion technique that is often used off-label although it has been shown to be effective. Acetaminophen (paracetamol) subcutaneous injection is performed in some centers despite the lack of conclusive evidence on its effectiveness. This study aims to evaluate the efficacy of subcutaneous infusion of Acetaminophen in the treatment of pain and fever in geriatrics and in palliative care and to determine its safety profile and possible side effects. Material and methods This experimental study was conducted between 2018 and 2019 on adult patients in palliative care or in geriatrics in several hospitals and nursing homes in Lebanon. Primary outcomes were change in temperature; change in pain score on the numerical rating scale (NS) or on the Algoplus scale after 60 min from the start of the infusion; and the appearance of local side effects at the infusion site. Changes in the various parameters at 30 min and 180 min were also evaluated as secondary outcomes. Results Thirty-one patients were included in the study, with a total of 120 doses of acetaminophen. At 60 min, the mean decrease in pain on the NS was 5.35 points, while the mean decrease in temperature was 0.79 degrees Celsius. At 60 min, 75%, CI = [47.62-92.73] of the patients who received acetaminophen for pain and 66.67%, CI = [38.38-88.17] of those who received it for fever had clinically significant improvement. The overall effect of subcutaneous acetaminophen, defined as any clinically significant effect on pain or fever, was 70.97%, CI = [51.96-85.78]. The overall effect at 30 min and at 180 min was 23.33%, CI = [9.93-42.28] and 87.10%, CI = [70.17-96.37], respectively. The side effects reported 30 min after the injection and observed after at least one of the doses were: local edema in 16 patients (51.61%), induration in one patient (3.23%), local pain in one patient (3.23%) and local heat in one patient (3.23%). At 180 min, only 2 patients (6.45%) still had edema at the infusion site. Conclusion Subcutaneous administration of acetaminophen is effective and well tolerated in geriatric and palliative care patients. It is appropriate when no other route is available, especially for home-based care. Comparative studies are needed to allow the expansion of this practice.
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Al-Hajj S, Ariss AB, Bachir R, Helou M, Zaghrini E, Fatouh F, Rahme R, El Sayed MJ. Paediatric injury in Beirut: a multicentre retrospective chart review study. BMJ Open 2022; 12:e055639. [PMID: 35338061 PMCID: PMC8961129 DOI: 10.1136/bmjopen-2021-055639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study aims to assess the epidemiology of paediatric injury in Beirut, giving insights into their characteristics, contributing risk factors and outcomes. DESIGN AND SETTING A retrospective study was conducted to review medical charts for children aged 0-15 years presented to five hospital emergency departments (ED) located in Beirut over a 1-year period (June 2017-May 2018). PARTICIPANTS A total of 1142 trauma-related visits for children under 15 years of age were included. A descriptive analysis and a bivariate analysis were performed to investigate admitted and treated/discharged patients. PRIMARY OUTCOME A logistic regression was conducted to identify factors associated with hospital admission among injured children. RESULTS A total of 1142 cases of paediatric injury ED cases were sampled, mean age was 7.7±4.35 years. Children aged 0-5 years accounted for more than one-third of the total cases, 40.0% (206/516) of the fall injuries and 60.1% (220/366) of home injuries. The leading cause of paediatric injury was fall (45.2%), nearly 4.1% of the cases were admitted to hospitals. Factors associated with admission included injury to abdomen (OR=8.25 (CI 1.11 to 61.24)), to upper extremity (OR=5.79 (CI 2.04 to 16.49)), to lower extremity (OR=5.55 (95% CI 2.02 to 15.20) and other insurance type (OR=8.33 (CI 2.19 to 31.67)). The three types of injuries mostly associated with hospital admission were fracture (OR=13.55 (CI 4.77 to 38.44)), concussion (OR=13.60 (CI 2.83 to 65.41)) and organ system injury (OR=31.63 (CI 3.45 to 290.11)). CONCLUSIONS Injury remains a major health problem among the paediatric population in Lebanon. Parental child safety educational programmes and age-targeted injury prevention strategies should be initiated and implemented to mitigate the burden of child injuries and improve child safety and well-being.
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Affiliation(s)
| | - Abdel-Badih Ariss
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Bachir
- American University of Beirut, Beirut, Lebanon
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Rizk Hospital, Beirut, Lebanon
| | - Elie Zaghrini
- Department of Emergency Medicine, Lebanese Hospital Geitawi, Beirut, Lebanon
| | - Fathalla Fatouh
- Department of Emergency Medicine, Harriri University Hospital, Beirut, Lebanon
| | - Rachid Rahme
- Sacre-Coeur Hospital, Baabda, Mont-Liban, Lebanon
| | - Mazen J El Sayed
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Khater DA, Daou R, Al Dailaty A, Helou M. Diphenhydramine induced acute dystonia: a case report. Pan Afr Med J 2022; 42:289. [DOI: 10.11604/pamj.2022.42.289.35167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/24/2022] [Indexed: 11/11/2022] Open
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Helou M, Van Berlaer G, Yammine K. Factors influencing the occurrence of infectious disease outbreaks in Lebanon since the Syrian crisis. Pathog Glob Health 2021; 116:13-21. [PMID: 34313580 DOI: 10.1080/20477724.2021.1957192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Since the beginning of the Syrian crisis in 2011, the region has witnessed a major population displacement. Lebanon, a country with a population of 4.2 million, has welcomed around one million refugees. A rise in the incidence of Measles, Hepatitis A and Leishmaniosis was noted. This paper aims to document the incidence of outbreaks along with the factors that contributed to their emergence in Lebanon. A comprehensive literature review was conducted using electronic databases and (non) governmental reports, including studies reporting the state of Syrian refugees in Lebanon and those reporting on infectious outbreaks in Lebanon and Syria. Primary outcomes were defined as incidence or prevalence of Measles, Hepatitis A, and Leishmaniosis in both populations. Secondary outcomes were set to be the risk factors for the outbreaks. As of February 2016, Lebanon registered a total of 1.067.785 refugees. Infectious outbreaks were reported in Lebanon just after initiation of Syrian migration, with 1760 new measles cases, 1551 hepatitis A cases, and 1033 Leishmania cases in 2013. Local factors probably contributing to the emergence and dissemination of the outbreaks include living conditions, water and sanitation, nutritional state, and immunization. The outbreaks were not only reported in regions with higher refugee concentration, but also within other Lebanese regions. This was attributed to deficiencies in immunization of measles, low socioeconomic status and poor living conditions. The Syrian crisis has led to considerable impact on the demographic, economic, and political systems in Lebanon, next to an important burden on the healthcare system.
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Affiliation(s)
- Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon
| | - Gerlant Van Berlaer
- Department of Emergency Medicine and Research Group on Emergency and Disaster Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Kaissar Yammine
- Department of Orthopedic Surgery, Lebanese American University Medical Center, Beirut, Lebanon
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Nakhle R, EL-Hussein, M, Zaatari G, Helou M. Survival after 43 minutes of cardiopulmonary resuscitation: A case report. Med Clin Sci 2021. [DOI: 10.33425/2690-5191.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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El Hajj C, Chardigny JM, Boirie Y, Yammine K, Helou M, Walrand S. Effect of Vitamin D Treatment on Glucose Homeostasis and Metabolism in Lebanese Older Adults: A Randomized Controlled Trial. J Nutr Health Aging 2018; 22:1128-1132. [PMID: 30379314 DOI: 10.1007/s12603-018-1083-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND A low serum 25-hydroxyvitamin D [(25(OH) D)] concentration was shown to correlate with higher fasting blood glucose (FBG) and insulin levels. Since age affect insulin sensitivity and the metabolism, we aimed in this randomized controlled trial to investigate the effect of vitamin D supplementation on glucose homeostasis and index of insulin resistance in elderly subjects living in Beirut, Lebanon. METHODS Participants (n= 115) deficient in vitamin D were randomly divided into two groups, a group receiving 30,000 IU cholecalciferol/week for a period of 6 months, and a placebo group. The index of insulin resistance HOMA (homeostasis model assessment) was the primary outcome. Glucose homeostasis and metabolic markers were also measured at start of treatment and at 6 months. RESULTS Vitamin D supplementation led to significant improvements in blood levels of [25(OH) D] (P< 0.0001), and a significant decreased of HOMA, PTH and FBG concentrations (P< 0.0001) in the intervention group compared to placebo. No significant changes were observed in HbA1c levels for both groups. Total cholesterol and LDL cholesterol concentrations have also decreased significantly in the intervention group (P< 0.0001). CONCLUSION Short-term supplementation with cholecalciferol improved vitamin D status, and markers of insulin resistance in healthy elder population. This trial was registered at ClinicalTrials.gov; Identifier number#:NCT03478475.
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Affiliation(s)
- C El Hajj
- Cynthia El Hajj, Département de Diététique et de Nutrition, Hôpital Saint-Charles, Beirut, Lebanon, , Tel: +9613409590
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Platt DE, Hariri E, Salameh P, Helou M, Sabbah N, Merhi M, Chammas E, Ammar W, Abchee AB, Zalloua PA. Association of waterpipe smoking with myocardial infarction and determinants of metabolic syndrome among catheterized patients. Inhal Toxicol 2017; 29:429-434. [PMID: 29064301 DOI: 10.1080/08958378.2017.1384085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Daniel E. Platt
- Bioinformatics and Pattern Discovery, IBM T. J. Watson Research Centre, Yorktown Heights, NY, USA
| | - Essa Hariri
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Pascale Salameh
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Mariana Helou
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Nada Sabbah
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Mahmoud Merhi
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Elie Chammas
- Department of Cardiology, Clemenceau Medical Center, Beirut, Lebanon
| | | | | | - Pierre A. Zalloua
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Harvard School of Public Health, Boston, MA, USA
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Helou M, Sakr R, Tanios A. Health status of Lebanese university students. Int J Community Med Public Health 2017. [DOI: 10.18203/2394-6040.ijcmph20172815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: In order to assess the health status of the students in Lebanese Universities, an epidemiological study was conducted in 3 Lebanese universities during the year 2014-2015.Methods: A standard anonymous questionnaire was distributed in 3 universities in Lebanon; questions were related to socio demographic characteristics, hygiene and lifestyle, social and behavioral life, and diseases.Results: We have collected 500 questionnaires, with a majority of females. Health status was perceived to be good or very good by most of the respondents. This was seen in the group with better sleeping hours. Most of the students were normally to extremely attentive to their hygiene, these students were found to be living at their parents’ house, and have been at least once this year for a medical check-up. Female sex and academic year differences were found related for stress perception and emotional reactions.Conclusions: This study presents some results that are fairly consistent with other foreign surveys. More research is needed to better evaluate the health determents of the students in order to recommend adequate preventive measures and consider generalization of the results to all the students in the Lebanese universities.
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Platt DE, Hariri E, Salameh P, Merhi M, Sabbah N, Helou M, Mouzaya F, Nemer R, Al-Sarraj Y, El-Shanti H, Abchee AB, Zalloua PA. Type II diabetes mellitus and hyperhomocysteinemia: a complex interaction. Diabetol Metab Syndr 2017; 9:19. [PMID: 28331553 PMCID: PMC5359933 DOI: 10.1186/s13098-017-0218-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/11/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Elevated homocysteine (Hc) levels have a well-established and clear causal relationship to epithelial damage leading to coronary artery disease. Furthermore, it is strongly associated with other metabolic syndrome variables, such as hypertension, which is correlated with type II diabetes mellitus (T2DM). Studies on T2DM in relation to Hc levels have shown both positive and negative associations. The aim of the present study is to examine the relationship between Hc levels and risk of T2DM in the Lebanese population. METHODS We sought to identify whether Hc associates positively or negatively with diabetes in a case-control study, where 2755 subjects enrolled from patients who had been catheterized for coronary artery diagnosis and treatment. We further sought to identify whether the gene variant MTHFR 667C>T is associated with T2DM, and how Hc and MTHFR 667C>T also impact other correlates of T2DM, including the widely used diuretics in this study population. RESULTS We found that Hc levels were significantly reduced among subjects with diabetes compared to those without diabetes when adjusted for all potential confounders (OR 0.640; 95% CI [0.44-0.92]; p = 0.0200). The associations between Hc levels and other variates contradicted the result: hypertension associates positively with high Hc levels, and with T2DM. The MTHFR 667C>T only associated significantly with high Hc levels. CONCLUSION These results suggest population-specific variations among a range of mechanisms that modulate the association of Hc and T2DM, providing a probe for future studies.
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Affiliation(s)
- Daniel E. Platt
- Bioinformatics and Pattern Discovery, IBM T. J. Watson Research Centre, Yorktown Hgts, NY 10598 USA
| | - Essa Hariri
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | - Pascale Salameh
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Mahmoud Merhi
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | - Nada Sabbah
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | - Mariana Helou
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | - Francis Mouzaya
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | - Rita Nemer
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
| | | | - Hatem El-Shanti
- Qatar Biomedical Research Institute, Doha, Qatar
- University of Iowa Carver College of Medicine, Iowa City, USA
| | - Antoine B. Abchee
- Division of Cardiology, Department of Internal Medicine, School of Medicine, American University of Beirut, P.O. Box: 11-0236, Riad-El-Solh, Beirut, 1107 2020 Lebanon
| | - Pierre A. Zalloua
- School of Medicine, Lebanese American University, Chouran, Beirut, 1102 2801 Lebanon
- Harvard School of Public Health, Boston, MA 02215 USA
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Abstract
BACKGROUND Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. MATERIALS AND METHODS A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. RESULTS The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. CONCLUSION Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.
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Affiliation(s)
- Mariana Helou
- Department of Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Grace Abi Rizk
- Department of Family Medicine, School of Medicine, Saint Joseph University, Beirut, Lebanon
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Mathieu M, Helou M, Morin G, Dolhem P, Devauchelle B, Piussan C. The KBG syndrome: an additional sporadic case. Genet Couns 2000; 11:33-5. [PMID: 10756425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We report the sporadic case of a boy with clinical features of KBG syndrome, including slight mental retardation, characteristic facies, macrodontia, and skeletal anomalies.
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Affiliation(s)
- M Mathieu
- Unité de Génétique Clinique, CHU Amiens, France
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