Pascale salameh
Lebanese University, Faculty of Public Health & of Pharmacy, Faculty Member
Studies concerning asthma in Lebanon investigated environmental and personal factors but none of them took into account the effect of nutritional habits. Our objective is to assess the effect of nutritional habits on asthma and allergies... more
Studies concerning asthma in Lebanon investigated environmental and personal factors but none of them took into account the effect of nutritional habits. Our objective is to assess the effect of nutritional habits on asthma and allergies in Lebanese children aged 3-16 years old. This is a case-control study, conducted between December 2015 and April 2016. The Food Frequency Questionnaire was composed of 16 semi-quantitative questions covering different food categories. This study included 1,276 children (976 healthy and 300 asthmatic children). Eating dairy products less than twice a week, 3-6 times per week and daily were significantly and inversely associated with asthma, as compared to never eating dairy products (p = 0.02, ORa = 0.285, CI 0.099-0.821; p < 0.001, ORa = 0.140, CI 0.052-0.378 and p < 0.001, ORa = 0.161, CI 0.061-0.422), whereas eating red meat daily compared to never was associated with asthma significantly (p = 0.037, ORa = 2.051, CI 1.046-4.024). Eating nuts less than twice weekly as compared to never was significantly and inversely associated with asthma (p = 0.035, ORa = 0.597, CI 0.369-0.965). The age categories 7-10 and 11-13 years were significantly associated with asthma as compared to the 3-6 years category (p < 0.001, ORa = 3.359, CI 1.869-6.038 and p = 0.008, ORa = 2.191, CI 1.228-3.909, respectively), while male gender was significantly more prone to asthma (p = 0.014, ORa = 0.686, CI 0.507-0.926). Knowing the correlation between nutritional habits and asthma is important to promote healthy eating. Educational programs for parents about healthy food and breastfeeding encouragement is warranted.
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Background: Teaching is a mentally and physically draining occupation, and due to the SARS-CoV-2 pandemic, the education system shifted to online platforms, which made it even harder. Lebanon is a developing country that is not well... more
Background: Teaching is a mentally and physically draining occupation, and due to the SARS-CoV-2 pandemic, the education system shifted to online platforms, which made it even harder. Lebanon is a developing country that is not well prepared for such a daunting outbreak. In addition to its tremendous economic crisis, it will be even harder for teachers to maintain mental stability. The aftermaths of this crisis could, perhaps, impact all the fundamental systems within the country including education Aim: This study aims to assess stress, anxiety, and depression levels among Lebanese schoolteachers based on the COVID-19 outbreak, the Lebanese economic crisis, and online education. Methods: A cross-sectional study was carried out, enrolling 300 schoolteachers currently working in Lebanon. An online survey was used, assessing sociodemographic factors, teaching status, financial wellness, fear of COVID-19, and mental health. The IFDFW scale is used to assess financial distress, DASS-21 ...
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Background Recently, new therapeutic approaches have revolutionized the management of left ventricular dysfunction (LVD) and valvular heart disease (VHD), which are a growing public health problem. In parallel, there are no available... more
Background Recently, new therapeutic approaches have revolutionized the management of left ventricular dysfunction (LVD) and valvular heart disease (VHD), which are a growing public health problem. In parallel, there are no available epidemiological data about LVD and VHD in developing countries, especially in the Mediterranean area. This retrospective study was conducted at a single center and aimed to evaluate the associations between mitral and aortic valvular disease and left ventricle systolic and diastolic dysfunction in the Lebanese population. Material/Methods A retrospective study was conducted of 4520 consecutive patients aged >18 years who were referred to the Cardiovascular Department of Notre Dame de Secours-University Hospital in Jbeil-Lebanon for transthoracic echocardiography between December 2016 and December 2019. The study population was divided into different groups based on types of LVD and VHD. Left ventricle systolic dysfunction was defined as a left ventri...
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Background: The Preschool Asthma Risk Factor Scale (PS-ARFS) is a tool that enables clinicians to assess environmental exposure of preschool children, history of parental asthma, and dietary habits. The objective of this study was to... more
Background: The Preschool Asthma Risk Factor Scale (PS-ARFS) is a tool that enables clinicians to assess environmental exposure of preschool children, history of parental asthma, and dietary habits. The objective of this study was to evaluate the PS-ARFS ability to predict asthma diagnosis and respiratory symptoms 1 year after baseline assessment and improve the scale if necessary.Methods: A prospective cohort study conducted between November 2018 and March 2019 in three Lebanese schools (from three different Lebanese Governorates) enrolled 515 preschool children aged 3–5 years. Parents completed a detailed questionnaire sent with their children (Phase 1; T0). All parents who participated in Phase 1 were invited to take the same survey by telephone (Phase 2; T1), 1 year later. The interview was conducted by one study-independent person. Of the total sample, 141 (27.4%) children were lost to follow-up.Results: Higher odds of asthma diagnosis at 1 year were significantly associated wi...
Research Interests: Pediatrics, Immunology, Asthma, Medicine, Odds ratio, and 3 moreOdds, Confidence Interval, and Bedroom
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Background Transcription is considered a critical step in the medication use process, particularly in hospitals that do not utilise any computerised physician order entry systems. Sequentially, pharmacists are responsible for order... more
Background Transcription is considered a critical step in the medication use process, particularly in hospitals that do not utilise any computerised physician order entry systems. Sequentially, pharmacists are responsible for order verification, a step that follows transcription. Accordingly, they are the last safety net to intercept and correct near miss transcription errors before reaching the patient Purpose The objective of this study was to assess the role of hospital pharmacist in preventing and reporting transcription errors Material and methods This was a retrospective observational study. All hospitalised patients in a tertiary care hospital admitted from January 2009 to December 2015 were included. Patients’ charts were screened for errors by clinical pharmacists. Medication related physician orders and home medication discharge orders were reviewed. All detected errors in the medication use process were recorded using a validated medication error reporting form. Results 734 transcription errors were identified in the charts of 30440 patients. Most reported transcription errors occurred in the department of internal medicine (72.3%) followed by surgery (9.9%). Approximately 52.9% of reported medication errors occurred with prescribed parenteral medications and 35% with orally administered drugs. Antimicrobials and cardiovascular medications were the main drug classes affected (24.5% and 14.8%, respectively). Results showed that the reasons behind errors were wrong doses (21.8%), drug omissions (20.6%), wrong medications (17.3%) and wrong drug frequencies (15.7%). Errors were classified as near miss in 91.3% of cases, while only 8.7% were considered errors that reached the patient with no harm done. It was noted that wrong dose and wrong bar code increased significantly the severity of errors, compared with drug omission (p=0.026 and p=0.001, respectively). With regard to drug classes, the results showed that analgesics, and respiratory and antidiabetic medications increased significantly the risk of errors compared with antibiotics (p=0.011; p=0.029; p=0.002, respectively). Finally, reporting errors from the medicine or surgery ward increased significantly the risk of error, compared with reporting from the pharmacy department (p=0.049). Conclusion In the absence of health information systems, pharmacists play a major role in preventing near miss transcription errors and securing patient safety. This is a continuous process through vigilant surveillance, proactive audits and effective reporting. No conflict of interest
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Background The rising threat of antibiotic resistance is linked to patterns of antibiotic use in hospital settings. Along the same lines, global efforts have been undertaken to encourage reporting and benchmarking antibiotic consumption... more
Background The rising threat of antibiotic resistance is linked to patterns of antibiotic use in hospital settings. Along the same lines, global efforts have been undertaken to encourage reporting and benchmarking antibiotic consumption in an attempt to decrease antibiotic resistance and improve antibiotic prescribing. Purpose The objective of this study was to assess antibiotic consumption in Lebanese hospitals based on a retrospective study conducted during 2012 for a 12 month period using pharmacy department records from 27 non-teaching hospitals across Lebanon and to compare these results with those from 2013–2014. Material and methods Data from each hospital were recorded based on the Anatomical, Therapeutic and Chemical classification system and defined daily dose (ATC/DDD), recommended by the WHO. Data included hospital demographic information and antibiotic consumptions by patient. Data were compiled and analysed using ABC Calc software V.3.1. Results Collected data in 2013–...
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BACKGROUND The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of... more
BACKGROUND The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults. METHODS This cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6±11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. RESULTS Body dissatisfaction was positively correlated to restrained eating (r=0.293, P<0.001), emotional eating (r=0.073, P=0.042) and binge eating (r=0.250, P<0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta=0.01, P<0.001) and orthorexia nervosa (Beta=-0.09, P<0.001), but not with emotional (Beta=-0.43, P=0.103) and binge eating (Beta=-0.08, P=0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only. CONCLUSION The interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.
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Summary Our study aimed at constructing and validating the Lebanese Osteoporosis Knowledge Scale adapted for use among Lebanese women and to assess factors associated with the poorest knowledge of osteoporosis definition, risk factors,... more
Summary Our study aimed at constructing and validating the Lebanese Osteoporosis Knowledge Scale adapted for use among Lebanese women and to assess factors associated with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. This scale showed adequate psychometric properties; higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. Introduction The primary objective of this study was to describe the construction of the Lebanese Osteoporosis Knowledge Scale (LOKS) and assess its psychometric properties in a representative sample of Lebanese women aged 40 years and above. Secondary objectives were to explore factors associated with this knowledge score. Methods A cross-sectional study carried out between March and June 2018, enrolled 560 women over the age of 40 years living in the community. This proportionate sample was randomly selected from all Lebanese governorates to cover the entire Lebanese area. A survey was developed and adapted to the Lebanese population based on preexisting scales. Personal interviews were conducted to collect data. Results The items of the LOKS were distributed across seven factors with an Eigenvalue over 1 solution, outlining an overall value of 55.89% of the variance. A high Cronbach’s alpha was found for the full scale (0.725). Individuals having a university level of education (beta = 1.62; compared to illiteracy), having heard of osteoporosis (beta = 2.62), taking supplements of calcium and vitamin D compared to none (beta = 0.77), and having had Crohn’s disease (beta = 1.71) had significantly higher knowledge scores of osteoporosis; oppositely, having diabetes (beta = − 1.17), currently taking chemotherapy (beta = − 2.25), and ever having had a fracture (beta = − 0.74) were significantly correlated with lower awareness of osteoporosis. Conclusions Our findings suggest that the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. A better knowledge seems to be associated with more preventive measures and less risk of fracture.
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BACKGROUND Malnutrition represents an important issue in older adults; unfortunately, there is lack of data concerning this topic in Lebanon. This paper aims to provide a description of nutritional status and its correlates in older... more
BACKGROUND Malnutrition represents an important issue in older adults; unfortunately, there is lack of data concerning this topic in Lebanon. This paper aims to provide a description of nutritional status and its correlates in older adults living in long stay institutions situated in Beirut. METHODS This cross-sectional study was conducted in three long stay institutions in Beirut in 2012. The study population was composed of people aged 65 years and above, having a score of Folstein Mini Mental State Examination (MMSE) greater than 14 and without renal failure requiring dialysis. Subjects meeting inclusion criteria filled out a questionnaire consisting of nutritional status scale (Mini Nutritional Assessment: MNA) and several other parts (demographic, self-assessment of the state health, smoking and alcohol, physical dependence, quality of life, frailty, depression, social isolation and loneliness). Data were entered and analyzed using the statistical software SPSS (Statistical Pac...
Research Interests: Health Sciences, Cognition, Lebanon, Medicine, Multivariate Analysis, and 14 moreMalnutrition, Humans, Nursing Homes, Female, Male, Body Mass Index, Aged, Prevalence, Geriatric Assessment, Cross Sectional Studies, Homes for the Aged, Surveys and Questionnaires, health status indicators, and Nutrition assessment
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Research is known to serve society and optimise educational institutions’ reputation, hand in hand with knowledge; this applies to all disciplines, including those related to health professions education, such as pharmacy and medicine.... more
Research is known to serve society and optimise educational institutions’ reputation, hand in hand with knowledge; this applies to all disciplines, including those related to health professions education, such as pharmacy and medicine. Institutional reputation attracts high-quality students and instructors, which will, in turn, enhance productivity and lead to a further better reputation. Reputation relies on branding strategies, encompassing research excellence as an intrinsic value and institutional ranking as an external recognition; additionally, institutional and programme accreditations both include quality standards related to research. However, in educational institutions, the research-education nexus faces many challenges, including lack of time due to education overloading and administrative duties, in addition to insufficient human and financial resources. Administrators need to facilitate an optimal research culture and an adequate context for cutting-edge research to be...
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Research is known to serve society and optimise educational institutions’ reputation, hand in hand with knowledge; this applies to all disciplines, including those related to health professions education, such as pharmacy and medicine.... more
Research is known to serve society and optimise educational institutions’ reputation, hand in hand with knowledge; this applies to all disciplines, including those related to health professions education, such as pharmacy and medicine. Institutional reputation attracts high-quality students and instructors, which will, in turn, enhance productivity and lead to a further better reputation. Reputation relies on branding strategies, encompassing research excellence as an intrinsic value and institutional ranking as an external recognition; additionally, institutional and programme accreditations both include quality standards related to research. However, in educational institutions, the research-education nexus faces many challenges, including lack of time due to education overloading and administrative duties, in addition to insufficient human and financial resources. Administrators need to facilitate an optimal research culture and an adequate context for cutting-edge research to be...
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Background and Objective Our aim is to investigate the impact of COVID-19 on screen time among Lebanese high school students (grades 9–12).Methods An anonymous online questionnaire was distributed among 510 school students from different... more
Background and Objective Our aim is to investigate the impact of COVID-19 on screen time among Lebanese high school students (grades 9–12).Methods An anonymous online questionnaire was distributed among 510 school students from different governorates in Lebanon; this included questions regarding screen time, food habits, and physical activity. Psychological symptoms were assessed using the Generalized Anxiety Disorder-7 items and Patient Health Questionnaire-9 items. Effects of screen time on sleep was evaluated using the Insomnia Severity Index and Bedtime Procrastination Scale.Results Female students reported higher depression (p = 0.018) and anxiety (p = 0.023) than male students; however, there was no difference in their sleep. Insomnia, depression, and anxiety were highest among phone users. A screen time of more than 7 hours per day was significantly associated with higher depression (67.9%), anxiety (61.6%), insomnia (82.1%), and bedtime procrastination. It also indicated a s...
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Objective This study aimed to explore whether screen time and the screen type impacted various health aspects of children, including physical activity (PA), sleep quality, and eating habits. Additionally, we investigated whether... more
Objective This study aimed to explore whether screen time and the screen type impacted various health aspects of children, including physical activity (PA), sleep quality, and eating habits. Additionally, we investigated whether children’s eating behavior while using electronic devices affects their physical and mental health.Methods We conducted an online survey asking for screen use (duration, type, and purpose), PA, eating habits, sleep problems, and level of depression. The participants were children between the ages of 3 and 7 years, and the survey was answered by the participants’ parents from March 3 to March 20, 2021.Results A screen time of ≥2 h in children was associated with various clinical characteristics, such as body mass index (BMI), sleep problems, depression, decreased PA, and unusual eating habits. Children’s food eating behavior while using electronic devices was predicted by a total screen time ≥2 h, smartphone screen time ≥2 h, sleep problems, owning electronic...
Various factors may confound how diabetes medications affect a patient's weight. Agents that induce hypoglycemia may promote weight gain through "defensive eating". Conversely , patients whose hyperglycemia exceeds the renal... more
Various factors may confound how diabetes medications affect a patient's weight. Agents that induce hypoglycemia may promote weight gain through "defensive eating". Conversely , patients whose hyperglycemia exceeds the renal glucose threshold may overeat to compensate for calories lost in urine and so gain weight when drug therapy ablates glycosuria. Some drugs, such as thiazolidinediones, may promote weight gain via increased lipid storage. Glucagon-like peptide-1 receptor agonists increase satiety, delay gastric emptying, and generally produce weight loss. Dipeptidyl peptidase (DPP)-4 inhibitors are generally weight-neutral, although modest weight loss has been observed with the DPP-4 inhibitor, vildagliptin, in patients with relatively low baseline glycemia. The weight neutrality of vildagliptin likely results in part from its intrinsically low risk for hypoglycemia. Recent studies point to additional potential mechanisms. One study found that drug-naïve patients ra...
The history of antimicrobial resistance (AMR) evolution and the diversity of the environmental resistome indicate that AMR is an ancient natural phenomenon. Acquired resistance is a public health concern influenced by the anthropogenic... more
The history of antimicrobial resistance (AMR) evolution and the diversity of the environmental resistome indicate that AMR is an ancient natural phenomenon. Acquired resistance is a public health concern influenced by the anthropogenic use of antibiotics, leading to the selection of resistant genes. Data show that AMR is spreading globally at different rates, outpacing all efforts to mitigate this crisis. The search for new antibiotic classes is one of the key strategies in the fight against AMR. Since the 1980s, newly marketed antibiotics were either modifications or improvements of known molecules. The World Health Organization (WHO) describes the current pipeline as bleak, and warns about the scarcity of new leads. A quantitative and qualitative analysis of the pre-clinical and clinical pipeline indicates that few antibiotics may reach the market in a few years, predominantly not those that fit the innovative requirements to tackle the challenging spread of AMR. Diversity and inn...
Research Interests: Medicine and Antibiotics
Abstract Therapeutic advances and the multiplicity of medications available to prevent or treat diseases have resulted in an increased risk of medication errors and adverse effects related to drug use. Therefore the challenge is to put in... more
Abstract Therapeutic advances and the multiplicity of medications available to prevent or treat diseases have resulted in an increased risk of medication errors and adverse effects related to drug use. Therefore the challenge is to put in place an integrative system, in addition to practices that would improve patient safety at all levels, medication safety in particular. Despite initiatives taken by various stakeholders, the medication safety system in Lebanon needs to be clearly defined in terms of assessment, strategic planning, and regulations, and implemented by the relevant authorities with the ultimate goal of serving patient health. This chapter aims at describing the present situation in Lebanon, highlighting current practices and the role of different stakeholders in addressing medication safety issues.
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Objective There is scarcity of reliable information on stroke in Lebanon. We aim to determine the potential risk factors for stroke in the Lebanese population. Design A retrospective case-control study was conducted between January 1st,... more
Objective There is scarcity of reliable information on stroke in Lebanon. We aim to determine the potential risk factors for stroke in the Lebanese population. Design A retrospective case-control study was conducted between January 1st, 2012 and December 31st, 2014 at two different tertiary hospitals in Lebanon. Data were collected through a designed data collection sheet. A multiple logistic regression determined stroke risk factors. The strength of association between the dependent variable and independent variables was expressed in odds ratio (OR) through 95% confidence interval. Setting Lebanon Participants Lebanese hospitalized patients. Main outcome measures Stroke risk factors Results Overall, 202 stroke cases and 530 stroke-free controls were included. The mean age of stroke was 68 ± 13 years. Age, smoking and a history of hypertension, cardiac arrhythmia, coronary heart disease/myocardial infarction, deep venous thrombosis/pulmonary embolism, and migraine were significantly...
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Lebanon is a small country located in the Middle East region which is undergoing rapid demographic transition. Among Arabic countries Lebanon has the fastest growing elderly population, and by the year 2025, older adults above 65 years... more
Lebanon is a small country located in the Middle East region which is undergoing rapid demographic transition. Among Arabic countries Lebanon has the fastest growing elderly population, and by the year 2025, older adults above 65 years are expected to represent more than 10% of the population. Nutrition is a key factor during the aging process and may help to prevent age-related diseases. However with increase in age, malnutrition is more frequent and might become an important health problem in the future. The prevalence of malnutrition among elderly people is particularly high in hospital environment and nursing homes compared to community settings, where mainly frail and dependent elderly are affected. Numerous factors are contributing to malnutrition such as age-related changes, social, physical, and psychological factors which are mostly acting in combination. The danger of malnutrition is related to its negative health consequences with increased risk of morbidity, functional decline, and decreased quality of life. Early detection and nutritional intervention may allow preventing negative health outcomes and increasing chance for healthy aging.
Objective: To describe the market share of importers, manufacturers and countries of origin of prescribed drugs in Lebanon; and to examine the effects of the price reductions enforced by the ministry of health on highly prescribed drugs.... more
Objective: To describe the market share of importers, manufacturers and countries of origin of prescribed drugs in Lebanon; and to examine the effects of the price reductions enforced by the ministry of health on highly prescribed drugs. Methods: 1326 medical prescriptions were collected from 3 different pharmacies in Mount Lebanon during the period July 2015 and February 2017. Costs were analyzed using 16 lists of drug prices from November 2014 to March 2017 provided by the ministry of public health. We also included the composition and therapeutic class of each medication. We used a one-tailed Z-test in order to check the validity of the claim that the reduction in prices enforced by the ministry of health affected highly prescribed drugs more than others on the total population of drugs prescribed. Results: Out of 4265 drugs in our prescriptions, 19.5% were manufactured in Lebanon and 61.9% imported from European countries whose manufacturers dominated the top 10 manufacturers co...
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Introduction: Antibiotic misuse is a worldwide public health problem and a major cause of antibiotic resistance. Objective: The aim of this study therefore was to describe the usage pattern of antibiotics in Lebanon. Method: It is a... more
Introduction: Antibiotic misuse is a worldwide public health problem and a major cause of antibiotic resistance. Objective: The aim of this study therefore was to describe the usage pattern of antibiotics in Lebanon. Method: It is a prospective study in a community-based pharmacy setting in Lebanon. It uses a structured random interview to patients visiting community pharmacy seeking for antibiotics. Baseline characteristics and reason for self-medication were collected. Completing a self-administered questionnaire after 30 days provided information on safety, efficacy and usage pattern. Data were analyzed using descriptive statistics and Chi-square test. Results: 62.7% of 501 participants bought antibiotic without prescription. Pharmacists were the main helpers (34.7%). Amoxicillin/clavulanic acid was the most used antibiotic as self-medication (33.7%). The overall average dispensation was 9.07 DDD for short term use (< 2 weeks). In the follow up, the average DDD consumed by pat...
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Title: Voluntary vs. Compulsory Student Evaluation of Clerkships: Effect on Validity and Potential Bias Authors: Sola Aoun Bahous (sola.bahous@lau.edu.lb) Pascale Salameh (pascalesalameh1@hotmail.com) Angelique Salloum... more
Title: Voluntary vs. Compulsory Student Evaluation of Clerkships: Effect on Validity and Potential Bias Authors: Sola Aoun Bahous (sola.bahous@lau.edu.lb) Pascale Salameh (pascalesalameh1@hotmail.com) Angelique Salloum (angelique.salloum@lau.edu.lb) Wael Salameh (wael.salame@lau.edu.lb) Yoon Soo Park (yspark2@uic.edu) Ara Tekian (tekian@uic.edu) Version: 1 Date: 26 Sep 2017 Author’s response to reviews: Ms. Ref. No.: MEED-D-17-00327 Title: Voluntary vs. Compulsory Student Evaluation of Clerkships: Effect on Validity and Potential Bias
Objective: The American Food and Drug Administration have warned about a possible association between statins and the development of new-onset diabetes. Lebanese studies lack sufficient data about this correlation. This study was... more
Objective: The American Food and Drug Administration have warned about a possible association between statins and the development of new-onset diabetes. Lebanese studies lack sufficient data about this correlation. This study was conducted to evaluate the clinical implication of statins on blood glucose levels among diabetic Lebanese hospitalized patients. Methods: A four-month retrospective observational study was conducted from February till May 2017. It included 131 type II diabetic patients stabilized on statins for a minimum of one year. In addition to statin type, strength, and duration, fasting blood glucose (FBG), glycosylated hemoglobin (Hba1c), body mass index (BMI), and lipid profiles were recorded. Results: The mean baseline FBG levels before the initiation of statins and post-statin intake were 115.25 mg/dL and 175.81 mg/dL for atorvastatin 10mg, 110.63 mg/dL and 183.16 mg/dL for atorvastatin 20mg, 119.25 mg/dL and 189.11mg/dl for atorvastatin 40mg, 123.21mg/dL and ...
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Scientific research on use and misuse of substances in Lebanon is scarce. This study aimed to evaluate the rate of use and abuse of substances among Lebanese youth and identify the determinants and risk factors behind these behaviours. An... more
Scientific research on use and misuse of substances in Lebanon is scarce. This study aimed to evaluate the rate of use and abuse of substances among Lebanese youth and identify the determinants and risk factors behind these behaviours. An observational survey was conducted on 1945 university students selected from the different faculties of the Lebanese University and other private universities. A self-administered questionnaire based on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) was administered. The prevalence of ever consuming alcohol was 20.9%. Cannabis (12.3%) and tranquilizers (11%) had the highest rates of ever use among the drugs, whereas cocaine (3.3%) and hallucinogens (3.6%) had the lowest rates. Smoking cigarettes and waterpipes, going out at night, peer pressure and having no specific leisure time activity were associated with problematic substance use, while a better relationship with parents, reading and working were inversely associated with u...
This study aims to investigate the positive association between a longer duration of breastfeeding and better health outcomes from birth to 36 months by using direct health outcomes and indirect health indicators. It is a cross-sectional... more
This study aims to investigate the positive association between a longer duration of breastfeeding and better health outcomes from birth to 36 months by using direct health outcomes and indirect health indicators. It is a cross-sectional study including 222 toddlers aged 12-48 months. Questionnaires were completed in 2015 by mothers who had attended at least one breastfeeding counselling seminar in Lebanon. Breastfeeding duration, sociodemographic variables and health indicators were collected and analysed. Results showed that the majority of infants (65.8%) did not receive formula milk right after birth and 28.4% never had formula milk. Thirty-two per cent were exclusively breastfed for 6 months and total breastfeeding duration exceeded 6 months for 74.8% of the sample. Longer durations of both exclusive and total breastfeeding were significantly associated with fewer paediatrician visits, fewer antibiotic prescriptions, a lower occurrence of colic, urinary tract infections and dec...
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Background: The increase in medication use and expansion of the pharmaceutical industry has led to an increase in hazards, errors and adverse events associated with medication use. In Lebanon, medication safety reporting by pharmacists is... more
Background: The increase in medication use and expansion of the pharmaceutical industry has led to an increase in hazards, errors and adverse events associated with medication use. In Lebanon, medication safety reporting by pharmacists is lacking due to the absence of an official reporting system.Objective: The objective of the Order of Pharmacists of Lebanon (OPL) was to engage pharmacists in reporting the adverse drug reactions by creating an efficient tool for this purpose.Methods: The scientific committee at the OPL worked on designing a reporting tool for adverse drug reactions (ADRs).Results: An electronic platform was created, and several training sessions were conducted for professionals who would be involved in helping community or hospital pharmacists in launching the platform. The form was tuned based on the findings of the Community pharmacists, hospital pharmacists and the general population questionnaires about medication safety culture, to fit the needs of the practic...
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Objective: to analyze the cost and type of pharmaceuticals prescribed to treat chronic diseases in Lebanon, particularly hypertension and diabetes. Methods: 1326 medical prescriptions were collected from 3 different pharmacies in Mount... more
Objective: to analyze the cost and type of pharmaceuticals prescribed to treat chronic diseases in Lebanon, particularly hypertension and diabetes. Methods: 1326 medical prescriptions were collected from 3 different pharmacies in Mount Lebanon during the period July 2015 and February 2017. Costs were analyzed using the list of drug prices of March 21, 2017 provided by the ministry of public health. We also included the composition and therapeutic class of each medication. Results: Out of 168 hypertension prescriptions, 50% included beta-blockers, 43.5% angiotensin receptor blockers, 41.7% diuretics and 40.5% calcium channel blockers. The most prescribed hypertensive medication was bisoprolol (35.1%), followed by hydrochlorothiazide (30%) which was also the most prescribed ingredient in association. Diuretics and beta-blockers were the least expensive (with medians of 5.4 and 6.6 USD respectively), while ACE inhibitors and angiotensin receptor blockers were the most expensive ones (w...
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Objectives: There is a Lack of previous evidence that measure patient-pharmacist relationship based on a theoretical framework. The aim of this study is to validate a measurement tool aid to measure the patient-pharmacist relationship in... more
Objectives: There is a Lack of previous evidence that measure patient-pharmacist relationship based on a theoretical framework. The aim of this study is to validate a measurement tool aid to measure the patient-pharmacist relationship in Lebanon based on a previously established conceptual model. Methods: A cross sectional study, conducted in all districts in Lebanon between January and April 2016, included 565 patients. Results: Patient perception, level of expectation and reasons for visiting the pharmacy were all significantly and highly correlated between them (0.799<r<0.878) (p<0.05 for all). High Cronbach’s alphas were found for level of expectation full scale (0.921) and the following factors: patient perception (0.926), the main reason for visiting back for the pharmacy (positive reactions) (0.804) and barriers for asking questions (negative reactions) (0.755).\ Conclusion: Our results show that the level of expectation of the patient is heightened when the perceive...
Research Interests: Medicine and Pharmacist
Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Medilab SARL Backgroung Given the expected epidemic rise of coronary heart disease (CHD) in healthcare system and the potential... more
Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Medilab SARL Backgroung Given the expected epidemic rise of coronary heart disease (CHD) in healthcare system and the potential severity of disease, CHD remains underestimated in women. Early identification of risk factors (RFs) will be important for their health promotion. Purpose The aim of this study is to evaluate the RFs for CHD among Lebanese women aged 40 years and above. Methods A case-control study was carried out in 6 hospitals in the regions of Beirut and Mount-Lebanon, from December 2018 to December 2019 with a total of 1500 patients. Anthropometric and laboratory data were collected from the medical records of patients and structured questionnaire were used. Results CHD was positively associated with hyperlipidemia (aOR 2.852, 95% CI: 2.021–4.023), hypertension (2.715, 1.598–4.614), family history of CHD (2.645, 1.925–3.634), smoking (1.888, 1.393–2.558) and in...
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Antibiotic resistance is an ecosystem problem threatening the interrelated human-animal-environment health under the “One Health” framework. Resistant bacteria arising in one geographical area can spread via cross-reservoir transmission... more
Antibiotic resistance is an ecosystem problem threatening the interrelated human-animal-environment health under the “One Health” framework. Resistant bacteria arising in one geographical area can spread via cross-reservoir transmission to other areas worldwide either by direct exposure or through the food chain and the environment. Drivers of antibiotic resistance are complex and multi-sectoral particularly in Lower- and Middle-income countries. These include inappropriate socio-ecological behaviors; poverty; overcrowding; lack of surveillance systems; food supply chain safety issues; highly contaminated waste effluents; and loose rules and regulations. In order to examine the drivers of antibiotic resistance from a “one health” perspective, a literature review was conducted on three databases including PubMed, Medline and Google Scholar. A total of 485 studies of potential relevance were selected, out of which 182 were included in this review. Results have shown that the aforement...
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Background: Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional... more
Background: Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. In 2017, the Official Pharmacists’ Association in Lebanon [OPL - Order of Pharmacists of Lebanon] took the initiative to develop a pharmacy core competency framework. Objective: The primary objective of this survey was to evaluate graduates' perceptions of pharmacy-related competencies “taught” across Lebanese pharmacy schools/faculties, based on the suggested Lebanese Pharmacy Competencies Framework. This study also explored the association between graduates' demographics, university attributes, and self-assessed competency performance. Methods: A cross-sectional study involving pha...
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Background: Dentists play an essential role in providing high-quality dental care, taking into consideration the clinical context and concomitant medications taken by the patients. Objective: This study aimed to assess drug-prescribing... more
Background: Dentists play an essential role in providing high-quality dental care, taking into consideration the clinical context and concomitant medications taken by the patients. Objective: This study aimed to assess drug-prescribing perception and practices in addition to drug-related educational needs among Lebanese dentists; it also evaluated the need for interprofessional collaboration between dentists and pharmacists. Methods: An exploratory cross-sectional study using an online questionnaire targeted a sample of dentists from all Lebanese districts. Participants gave their consent by accepting to complete the survey (ethics approval reference: USJ-2016-63). The questionnaire consisted of closed-ended questions exploring: 1) drug-prescribing perception, 2) drug-prescribing practice, and 3) collaboration with pharmacists regarding their respective roles in providing appropriate counseling to patients. Two indexes were created: the first evaluated self-confidence in prescribing...
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BackgroundCOVID-19 is a respiratory disease that results in a prothrombotic state manifesting as thrombotic, microthrombotic and thromboembolic events. As a result, several antithrombotic modalities have been implicated in the treatment... more
BackgroundCOVID-19 is a respiratory disease that results in a prothrombotic state manifesting as thrombotic, microthrombotic and thromboembolic events. As a result, several antithrombotic modalities have been implicated in the treatment of this disease. This study aimed to identify if therapeutic anticoagulation (TAC) or concurrent use of antiplatelet and anticoagulants was associated with an improved outcome in this patient population.MethodsA retrospective observational cohort study of adult patients admitted to a single university hospital for COVID-19 infection was performed. The primary outcome was a composite of in-hospital mortality, intensive care unit (ICU) admission or the need for mechanical ventilation. The secondary outcomes were each of the components of the primary outcome, in-hospital mortality, ICU admission, or the need for mechanical ventilation.Results242 patients were included in the study and divided into four subgroups: Therapeutic anticoagulation (TAC), proph...
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Objective: To assess work fatigue and its associated factors among community pharmacists in Lebanon. Methods: This cross-sectional study was conducted between March and July 2018. A proportionate sample of 435 community pharmacists was... more
Objective: To assess work fatigue and its associated factors among community pharmacists in Lebanon. Methods: This cross-sectional study was conducted between March and July 2018. A proportionate sample of 435 community pharmacists was selected from all regions of Lebanon. A standardized self-administered questionnaire, distributed by trained interviewers, was used to assess the studied variables. Results: The results showed that 50.12% of the pharmacists had emotional work fatigue [95%CI 0.454-0.549], 55.01% had mental work fatigue [95%CI 0.503-0.597], and 54.78% had physical work fatigue [95%CI 0.501-0.595]. Higher mental work fatigue was significantly associated with higher stress (Beta=0.185) and having a master’s degree compared to a bachelor’s degree (Beta=2.23). Higher emotional work fatigue was significantly associated with higher stress (Beta=0.219), working more than 40 hours compared to ≤ 16 hours (Beta=2.742), and having 6 months to less than 1 year of practice compared ...