2024-03-29T15:13:08Zhttps://laur.lau.edu.lb:8443/oai/requestoai:laur.lau.edu.lb:10725/4312023-05-10T09:56:17Zcom_10725_2058col_10725_2074
Clinical analysis of commonly used calcium, calcium/vitamin D tablets in Lebanon. (c1999)
Barada, Sana Ali
Itani, Siham Moh'd Kheir
Calcium -- Analysis
Vitamin D -- Analysis
Calcium -- Analysis -- Laboratory manuals
Calcium -- Therapeutic use -- Testing
Osteoporosis -- Prevention
Includes bibliographical references (leaves 34-39).
Osteoporosis is one of the commonest public health problems of modern medicine. It is the major underlying cause of bone fractures in postmenopausal women and elderly. Factors that influence the occurrence of osteoporosis include:
a-Optimal peak bone mass attained in the first 2 to 3 decades of life.
b-And the rate at which bone is lost in later years.
Calcium intake is one of a number of factors that affect peak bone mass. Adequate calcium intake is critical to achieving optimal peak bone mass and modifies the rate of bone loss associated with aging. The critical importance of calcium on skeletal health is illustrated in the National Institute of Health Consensus Panel recommendations that are age and gender specific. Calcium, which is a major component of mineralized tissues and is required for normal growth and development of the skeleton and teeth, can be provided through dairy products or calcium supplements. However, accuracy of calcium or calcium/vitamin D products is undetermined. Furthermore, certain reports from the US raise concern regarding the contamination of certain calcium supplements with heavy metals. The purpose of this investigation is to evaluate the purity and accuracy of commonly used calcium and calcium/vitamin D supplements in Lebanon. This investigation was a collaborative project between LAU and AUB-MC. The extraction and analytical studies were performed at the core research facility of faculty of medicine at AUB and the university Core Environment Laboratory.
2011-05-05T09:00:15Z
2011-05-05T09:00:15Z
2011-05-05
1999-07-01
Other
http://hdl.handle.net/10725/431
https://doi.org/10.26756/th.2023.574
en
oai:laur.lau.edu.lb:10725/4372017-09-25T07:06:54Zcom_10725_2058col_10725_2074
The chemical analysis of Lebanese olive oil and the influence of oil enriched diet on Plasma Lipid profile in rats. (c2002)
Zarikian, Karen Awadis
Oils and fats -- Analysis
Lipoproteins
Lipids in human nutrition
In the second half of this century, emphasis on diet related diseases increased as the major cause of mortality shifted from infections to chronic diseases. Cardiovascular disease (CYD) has been the number one killer in the United States since 1900. According to the American Heart Association 2002 Heart Statistical Update, one death is reported from CYD every 33 seconds. Atherosclerosis is the major underlying cause of coronary heart disease. Diet rich with cholesterol and saturated fat is believed to increase plasma levels of total and low density lipoprotein cholesterol, the primary lipoprotein mediating atherosclerosis. According to the 200 I guidelines of the National Cholesterol
Education Program Panel III, dietary treatment must proceed pharmacological therapy in hyperlipidemic patients for a three month period. It has been hypothesized that vegetable oils such as olive oil, canola oil, soybean oil, are major sources of monounsaturated and polyunsaturated fatty acids and that they have more favorable effects on the distribution of cholesterol. Olive Oil is the major fat used in the Mediterranean diet. Different environmental factors and harvesting techniques influence the chemical composition of olive oil. The primary objective of this study was to identify the fatty acid, sterol and squalene concentrations and acidity in the Lebanese olive oil prepared by the cold press and automated methods. Another objective was to observe the influence of a ten week olive oil enriched diet on the plasma lipid profile, insulin levels, coagulation time and Apolipoprotein B 100 and B 48 levels in rats. Olive oil samples were obtained from 11 different Lebanese areas. The identification of the fatty acids, sterols and squalene was performed on gas chromatography mass spectrometry (GeMS) and the acidity was identified by titration. In the second phase of the study, 42 rats were divided into three groups and fed for J 0 weeks the following diets: a) normal rat diet, b ) diet enriched with olive oil prepared by the automated method and c ) diet enriched with oil prepared by the cold press method. The oil of black olives prepared by the automated method from Beshaale (Northern Lebanon) contained the highest percentage of oleic acid and sterol concentration whereas the oil from Zrarieh (southern Lebanon) contained the least. On the other hand, the highest squalene concentration was found oil obtained from green olives brought from Beshaale. The most acidic oil was the one obtained from Koura, Kfar Akka (northern Lebanon), prepared by the automated method. Following ten week low fat verses high fat diet, no significant difference was observed among the various groups in lipid profile, insulin and Apo B 100 & 48 levels. There was a decrease in clotting time in the group fed the automated olive oil compared to the control and an increase in the clotting time in the group fed cold press olive oil compared to the automated. These findings suggest possible altered fat metabolism in rats. Further studies in humans might yield better conclusive results. In conclusion, the present study was able to identify the chemical composition of Lebanese olive oil in terms of fatty acids, sterols and squalene content. In addition, the increased acidity in some of the consumed olive oils is of great concern. In order to observe difference in lipid profile, well designed dietary experiments in humans is needed, because the squalene metabolism in rats is different than in humans.
2011-05-10T05:42:58Z
2011-05-10T05:42:58Z
2002
2011-05-10
2002-07-01
Thesis
http://hdl.handle.net/10725/437
https://doi.org/10.26756/th.2002.8
en
oai:laur.lau.edu.lb:10725/4602017-09-25T07:06:55Zcom_10725_2058col_10725_2074
Ultra-short therapy for the treatment of Helicobacter pylori. (c2001)
Chahine, Corinne
Helicobacter pylori
Helicobacter pylori infections
Background: Treatment regimens for Helicobacter pylori (H. pylori) usually combine an acid reducing agent (proton-pump inhibitor, H2-antagonist) with two or three antibiotics (macrolide, metronidazole, tetracycline, amoxicillin), with a duration varying from seven to fourteen days. Recently, studies have shown acceptable eradication rates using short-term triple-therapy regimens. Azithromycin, a new generation macrolide with improved pharmacokinetic properties (long t1/2 life and large volume of distribution), has been proposed for H. pylori treatment with variable radication rates of 57% to 93%. Objectives: The purpose of this study is to establish the safety and efficacy of two short-term triple-therapy regimens (lansoprazole, azithromycin and amoxicillin) for H. pylori eradication. Methods: From April 2000 to September 2000 thirty symptomatic patients with a positive rapid urease assay for H. pylori were assigned to receive either a 3-day therapy (Group A) or a 5-day therapy (Group B). In both groups, patients received lansoprazole 30mg bid on day 1; lansoprazole 30mg bid, amoxicillin 19 bid and azithromycin on days 2 and 3. Patients in group B received lansoprazole 30mg bid and amoxicillin 19 bid for two additional days (4 and 5). In-vitro antimicrobial susceptibility of H. pylori recovered from gastric biopsies was tested using the epsilometer test (E-test). Compliance and side effects were monitored. Evaluation of H. pylori eradication was done a minimum of four weeks after end of therapy using the 14C-urea breath test.
2011-05-13T08:26:54Z
2011-05-13T08:26:54Z
2001
2011-05-13
2001-06-08
Thesis
http://hdl.handle.net/10725/460
https://doi.org/10.26756/th.2001.2
en
oai:laur.lau.edu.lb:10725/4612017-09-25T07:06:55Zcom_10725_2058col_10725_2074
A comparative single-dose bioequivalence study of two enteric coated Aspirin brands among healthy volunteers. (c2001)
Zeitoun, Abeer Abbas
Aspirin
Aspirin -- Drug effects
(Aspicot®) is an enteric coated aspirin that is being extensively used among patients in the Middle East, including Lebanon where this drug is manufactured, without any clinical in-vivo implication showing or confirming its bioequivalence. Therefore, this investigation was carried out LO evaluate the in-vitro dissolution as well as the bioavailability and pharmacokinetic properties of two tablet oral dosage forms of enteric coated aspirin, Aspirin Protect® (Bayer©, Germany) and Aspicot® (Pharmaline©, Lebanon) in a single dose of 200 mg among healthy volunteers.
Method: Twelve healthy volunteers (seven males, five females), were enrolled in the study. Each volunteer received a single dose of each drug in an open randomized two-way crossover study, with a washout period of seven days. Blood samples were obtained at different time intervals over a period of 12 hours. These samples were then analyzed for serum acetylsalicylic acid and salicylic acid levels, using a sensitive HPLC assay.
Results: The two products were found to comply with the compendial requirements for both disintegration and content uniformity; and their in -vitro dissolution characteristics were similar. Moreover, there was no statistically significant difference with respect to peak serum concentration (The Cmax values for Aspicot® (23,66 ± 16,26 ~g / mL) and Aspirin Protect® (21.73 ± 11.33 ug / mL) or to corresponding peaks time (the Tmax values ( 4,92 ± 2.35 hours and 4,58 ± 1,5 1 hours for Aspicot® and Aspirin Protect® respectively), Furthermore, the difference between area under the serum concentration time curve for the two products (the AUC for Aspicot® (66,20 ± 42,90 ug / mL) and Aspirin Protect® (64,79 ± 38,02 ug / mL) was not statistically significant, with P > 0,05.
Conclusion: The findings in this study indicate that the two products are bioequivalent in terms of bioavailability and pharmacokinetic properties on healthy volunteers.
2011-05-13T09:15:12Z
2011-05-13T09:15:12Z
2001
2011-05-13
2001-06-17
Thesis
http://hdl.handle.net/10725/461
https://doi.org/10.26756/th.2001.3
en
oai:laur.lau.edu.lb:10725/5602017-09-25T07:06:57Zcom_10725_2058col_10725_2074
Sequential therapy in patients receiving Fluoroquinolones at the American University of Beirut Medical Center. (c2001)
Homsi, Maria
Antibiotics -- Therapeutic use
Antibiotics -- Physiological effect
Availability of oral antibiotics with superior pharmacokinetic profiles and safety has enabled early conversion from parenteral to oral antibiotic therapy in attempt to reduce overall cost. In Lebanon, no hospital has set guidelines regarding switching from intravenous (IV) to oral (PO) antibiotics. The objective of this study was to evaluate such practice at a tertiary care medical center. Patients admitted to AUBMC, receiving intravenous ciprofloxacin, levofloxacin, or ofloxacin were enrolled prospectively. Variables were collected daily from admission until discharge, including antibiotics prescribed, vital signs, CBC, and cultures. Date of switch (if applicable), oral antibiotic chosen, mean time to switch, mean hospital duration, and mean treatment duration were also recorded. Patients were evaluated for appropriateness of switch according to set guidelines summarized from previously published data. 195 patients were divided into three groups depending on the quinolone prescribed. Patients were then divided into two groups: treatment and prophylaxis, in which there were 124 and 71 patients respectively. Only 54.8% were switched. 53.6% of patients not switched could have been eligible candidates for oral therapy. Mean time to switch was 4.7 days, 4.6 days, and 3.6 days for the ofloxacin, levofloxacin, and ciprofloxacin groups respectively. While the mean time to switch was similar in the three groups, ciprofloxacin patients had a slightly longer duration of treatment at home. Identification of hospitalized patients eligible for switch therapy should be a target for intervention to hospitals in effort to decrease cost.
2011-09-14T11:13:31Z
2011-09-14T11:13:31Z
2001
2011-09-14
2001-10-11
Thesis
http://hdl.handle.net/10725/560
https://doi.org/10.26756/th.2001.6
en
oai:laur.lau.edu.lb:10725/6592019-09-11T07:06:29Zcom_10725_2058col_10725_2074
National cholesterol education panel III. (c2005)
Alameddine, Yasmine
Geitany, Rouba
Afiouni, Fadi
Myocardial infarction -- Patients -- Lebanon
Myocardial infarction -- Prevention
Myocardial infarction -- Treatment
Hypercholesteremia -- Treatment
Hypercholesteremia -- Prevention
Cholesterol -- Treatment
Patient education
Includes bibliographical references (leaves 15-17).
Purpose: The National Cholesterol Education Program (NCEP) III guidelines have been
hailed as an improvement in their potential to identify individuals at risk for coronary
heart disease (CHD) complications. Compared with the NCEP II, the new guidelines will
increase the number of patients who qualify for medical management. However, the
etIectiveness of these guidelines to identify young adults at risk for a cardiac event is yet
to be studied. The purpose of this study was to investigate the utility of the new NCEP III
guidelines in a group of young adults. Methods: A retrospective review of clinical data from young adults (age::; 55 years for
men and::; 65 years for women) hospitalized for acute myocardial infarction over a twoyear
period was conducted. Patients with a history of CHD or CHD equivalent were
excluded. Using the NCEP III guidelines, we calculated a lO-year risk for coronary
events on all patients. Results: A total of200 patients met criteria for inclusion. The mean age was 49 years
and 31 % were women. Mean lipid levels were all within the normal range, however, rates
of smoking and obesity were high. When the 10-year risk of these patients was stratified
by the number of risk factors and low-density lipoprotein cholesterol level, only 20% met
criteria to qualify for pharmacotherapy. Conclusion: The new guidelines offer multiple new features but have a tendency to
under appreciate the risk for disease in young adults. To improve performance in young
adults, statistical adjustments may be necessary.
2011-09-29T11:55:16Z
2011-09-29T11:55:16Z
2005
2011-09-29
2005-02-24
Thesis
http://hdl.handle.net/10725/659
https://doi.org/10.26756/th.2005.35
en
oai:laur.lau.edu.lb:10725/7182017-09-25T07:08:38Zcom_10725_2058col_10725_2074
The impact of drugs on congenital anomalies. (c1999)
Farah, Chantal Emile
Fetus -- Effect of drugs on
Congenital toxoplasmosis
Toxoplasmosis
Drug receptors
Some abnormalities that occur in the fetus and the newborn are of genetic origin,
some result of an infection , some are due directly or indirectly to incidental
complications of pregnancy and in some cases the cause is unknown or due to
incorrect drug intake.
Women commonly ingest medications or drugs while pregnant; some of these
drugs may be teratogenic. Major malformations are usually the result of the first
trimester exposure during critical periods of organogenesis. Therefore, pregnant
women should be discouraged from taking Over-the-Counter drugs, and such
drugs should not be taken without counseling. For prescription drugs, risks versus
benefits should be taken into consideration by the physician. The safe use of a drug in a single pregnancy or even in a large number of
pregnancies does not assure that the drug is safe in all pregnancies. Very few
medicinal agents can be declared safe in pregnancy. Because any drug can be
teratogenic, it is important to develop effective methods to prevent fetal exposure.
2011-10-10T09:41:43Z
2011-10-10T09:41:43Z
1999
2011-10-10
1999-07-06
Thesis
http://hdl.handle.net/10725/718
https://doi.org/10.26756/th.1999.8
en
oai:laur.lau.edu.lb:10725/7532020-04-30T09:33:27Zcom_10725_2058col_10725_2074
An overview of Attention Deficit Hyperactivity Disorder. (c1999)
Sadek, Maha
Hyperactive children
Attention-deficit hyperactivity disorder
Attention-deficit-disordered children
Attention-deficit hyperactivity disorder -- Treatment
Includes bibliographical reference (leaves 59-60).
2011-10-13T06:21:36Z
2011-10-13T06:21:36Z
1999
2011-10-13
1999-07-07
Thesis
http://hdl.handle.net/10725/753
https://doi.org/10.26756/th.1999.10
en
oai:laur.lau.edu.lb:10725/7572017-09-25T07:08:39Zcom_10725_2058col_10725_2074
Treatment of acute Mania. (c1999)
Taissoun, Hala Issam
Manic-depressive illness -- Popular works
Mania -- Therapy
Background:
Bipolar disorder is a relatively common disorder and is characterized by
"unpredictable swings in mood from mania to depression".
Mania is a disease state which induces difficulties in work performance
and psychosocial functioning requiring rapid and effective treatment in
order to allow the patients to return to nonnal function.
It is a very serious illness characterized by a high rate of recurrence and a
deteriorating course.
The treatment of acute mania should not only be effective and well
tolerated but also anticipate and modify the future course of illness.
Lithium, anticonvulsants, antipsychotics and EeT are recognized
treatments for acute marna.
Although lithium is considered by most as the treatment of choice, the
position of anticonvulsants and EeT is currently gaining ground.
Objectives:
This study is aimed at determining which treatment is most adequate for
acute mania.
..... Each treatment modality will be discussed separately before comparing
the three strategies for efficacy, safety and time taken to achieve the goals
set.
Methods and data analysis:
All patients diagnosed with acute mama will be considered for this study.
A non-randomized, open-label, comparative study will be conducted in a
single center where patients will be assigned into three groups: the ones
receiving lithium, the ones on anticonvulsants( carbamazepine or
valproate) and fmally patients receiving EeT.
Treatments are given depending on the patients' physician.
All information concerning patients will be available through their files or medical records. The study data will be entered into a patient information database, using
the SPSS Data Entry Program.
Significance:
Different studies have been conducted lately comparing various
treatments of mania.
Most of these have come out with contradicting results. So the question
remains open as to which strategy should the first line treatment for acute
mama.
And because mania is such a severe disease with many complications, it
would be interesting to find the answer.
2011-10-13T08:53:24Z
2011-10-13T08:53:24Z
1999
2011-10-13
1999-07-07
Thesis
http://hdl.handle.net/10725/757
https://doi.org/10.26756/th.1999.11
en
oai:laur.lau.edu.lb:10725/7692019-09-11T07:16:53Zcom_10725_2058col_10725_2074
Safety and efficacy of a ten day helicobacter pylori eradication regimen with rabeprazole, amoxicillin and clarithromycin. (c2003)
Farchoukh, Lina
Haidar, Cyrine-Eliana
Helicobacter pylori
Proton pump inhibitors
Includes bibliographical references (leaves 56-64).
OBJECTIVE: We assessed the safety and efficacy of a 1 a-day twice daily
rabeprazole-based triple therapy for Helicobacler pylori (H .pylon).
METHODS: H. pylori infected patients as confirmed by a rapid urease test
were enrolled in an outpatient based open-label prospective trial.
Symptomatic H. pylori infected patients were assigned to receive amoxicillin
1000 mg, clarithromycin 500 mg and rabeprazole 20 mg all twice daily for 10
days. No maintenance therapy was given during the follow up period. Patients
were followed up during therapy by telephone calls to assess compliance and
any occurrence of adverse effects. The efficacy endpoint was assessed by
using the 14_C urea breath test (UBT). Occurrence of side effects was also
evaluated. RESULTS: A total of 104 patients were analyzed per intention-to-treat (ITT)
and per-protocol (PP). Eradication rates of 87.5% (ITT) and 93.8% (PP) were
obtained. Therapy was relatively well tolerated with minimal side effects. CONCLUSION: Rabeprazole-based triple therapy is a suitable regimen for
eradication of H. pylori infection.
2011-10-13T12:23:17Z
2011-10-13T12:23:17Z
2003
2011-10-13
2003-07-03
Thesis
http://hdl.handle.net/10725/769
https://doi.org/10.26756/th.2003.10
en
oai:laur.lau.edu.lb:10725/7752017-09-25T07:08:40Zcom_10725_2058col_10725_2074
The role of Homocysteine, Folic Acid, Vitamin B6, Vitamin B12 in development of coronary heart disease in Lebanon. (c1999)
Domiati, Souraya
Hdeab, Fadi
Vitamins -- Physiological effect
Vitamin B12
Vitamin B-6
Coronary heart disease
2011-10-14T09:28:47Z
2011-10-14T09:28:47Z
1999
2011-10-14
1999-06
Thesis
http://hdl.handle.net/10725/775
https://doi.org/10.26756/th.1999.12
en
oai:laur.lau.edu.lb:10725/7762017-09-25T07:08:40Zcom_10725_2058col_10725_2074
A comparative single-dose bioequivalence study of two Glibenclamide brands among healthy volunteers. (c2000)
Tannous, Elias Fouad
Glibenclamide
Diabetes Mellitus, Experimental
Diabetes Mellitus -- Drug therapy
Glibenclamide is a second generation sulfonylurea oral hypoglycemic agent
that plays an important role in the therapy of type II diabetes mellitus (DM-II);
moreover. glibenclamide (Glibamid®) is being extensively used among diabetics in
the middle east, including Lebanon where this drug is manufactured, without any
clinical in vivo implication showing or confirming its bioequivalency. So, this
investigation was carried out to evaluate the in vitro dissolution as well as the
bioavailability and pharmacokinetic properties of two tablet oral dosage forms of
glibenclamide, Daonil® (drug A) and Glibamid® (drug B) in a single dose of 5 mg
among healthy volunteers. The two products were found to comply with the compendial requirments for both
disintegration and content uniformity; moreover, the 111 vitro dissolution
characteristics of the two products were similar.
Method: Ten healthy male volunteers were enrolled in the study, each
received a single dose of each drug in an open randomizes two-way cross-over study,
with a wash out period of 7 days. Blood samples were obtained over a 10 hours
interval according to this fashion: At zero, 0.5, 1, 1.5, 2, 2.5 , 3, 4, 5, 6, 8, and 10
hours. These samples were analyzed for serum glucose by the glucose oxidase method
and glibenclamide by a sensitive HPLC assay. Results.· The two products were closely related in terms of their in vitro
compendial requirements. Moreover, there was no significant difference with respect
to peak serum concentration (103.92 ± 43.98 and 98.5 ± 51.26 nglml for products A
and B, respectively) or to the corresponding peak times (2.6 ± 0.66 and 2.3 ± 0.88
hours for A and B respectively) . Furthermore, the difference between area under
serum concentration-time curve (AUC) for the two products ( 390.86 ± 152.61 and
360.7 ± 160.21 ng hr Iml for A and B, respectively) was not statistically significant,
with P > 0.05. The comparable serum glucose levels for the two products supported
the pharmacodynamical equivalence between the two glibenclamide brands. Conclusion: The findings in this study indicates that the two products of
glibenclamide are bioequivalent in terms of bioavailability and pharmacodynamic
effect on healthy male volunteers.
2011-10-14T11:30:14Z
2011-10-14T11:30:14Z
2000
2011-10-14
2000-06-29
Thesis
http://hdl.handle.net/10725/776
https://doi.org/10.26756/th.2000.6
en
oai:laur.lau.edu.lb:10725/7792017-09-25T07:08:40Zcom_10725_2058col_10725_2074
Empiric antibiotic therapy of community-acquired Pneumonia at the American University of Beirut Medical Center. (c2001)
Cherfan, Antoine
Pneumonia
Antibiotics -- Therapeutic use
The emergence of resistance among Streptococcus pneumoniae strains have led to
the development of several guidelines for the treatment of community-acquired
Pneumonia (CAP). Our purpose is to compare CAP empiric treatment practices
in patients hospitalized at a tertiary care medical center to those of the Infectious
Disease Society of America guidelines. In a six-month period, patients over 18
years of age were included in a prospective open label observational study if a
clinician documented an initial working diagnosis of pneumonia or if a chest xray
performed within the first 48 hours of hospitalization is reported consistent
with pneumonia. Patients were excluded if they were HIV positive, neutropenic,
had been hospitalized within the previous 10 days, had a history of organ transplant, had been exposed to chemotherapy or immunosuppressive therapy
within the previous two month, had been transferred from another acute care
facility. Hospitalization need per the Pneumonia Port criteria was evaluated; in
addition to the initial antimicrobial regimen, course of treatment, microbiology,
and outcome. Initial antimicrobial regimen was defined as all antibiotics used
during the first 48 hours of hospitalization. Outcome variables evaluated were
the length of stay, success or failure of therapy. Success of therapy was defined
as improvement in clinical or objective parameters. Failure was considered if the patient's antimicrobial regimen was changed or if there is clinical deterioration
from baseline.
65 eligible patients were identified with a mean age of 62.5 ± 18 years. 63 patients
were treated in the medical ward and two patients in the intensive care unit. Per
the pneumonia PORT prediction rule, there was overhospitalization by 50% .41
patients received single therapy regimen with Levofloxacin being the most used
single agent (51 %). The remaining 24 patients received combination therapy
primarily using a third generation cephalosporin (not Ceftazidime) with a
macrolide (75%). Success rate was 87.8% and 90.9% in single and combination
therapy groups respectively. Microbiological yield was very low for both sputum
and blood samples. In most of the cases, initial antibiotic regimen at AUBMC was appropriate and in
accordance with the IDSA guidelines. Special attention should be given to
decrease hospitalization rate, to preserve fluoroquinolones, and to improve
microbiological studies outcome.
2011-10-14T12:35:43Z
2011-10-14T12:35:43Z
2001
2011-10-14
2001-07-01
Thesis
http://hdl.handle.net/10725/779
https://doi.org/10.26756/th.2001.18
en
oai:laur.lau.edu.lb:10725/7922019-09-11T07:08:33Zcom_10725_2058col_10725_2074
Evaluation of antibiotic prophylaxis and factors affecting the incidence of surgical site infections in cardiac surgery at a tertiary medical center in Lebanon. (c2004)
Khatib, Zein Ahmad El-
Antibiotics -- Therapeutic use
Surgical wound infections -- Prevention
Medicine, Preventive
Includes bibliographical references.
Background: Appropriate antibiotic prophylaxis can reduce the incidence of
surgical site infections (SSI) in many procedures. Although its role is still
controversial in a clean surgery such as cardiac, antibiotic prophylaxis has been
suggested by many guidelines to avoid the significant morbidity and mortality
precipitated by surgical site infections (superficial or deep, leg or sternal). Objectives: The main objective of this study is to evaluate the adherence to
rational antibiotic prophylaxis for Open heart surgery at AUB-MC with major
criteria being: antibiotic regimen, dose, timing, and duration. In addition, the
secondary objectives are to detect the surgical site infection incidence and to
identify potential risk factors for infection. Based on the results, recommendation
regarding the antibiotic prophylaxis will be made. Materials and Methods: All medical charts of patients undergoing Open heart
surgery between October 2002 and April 2003 at AUB-MC and satisfying the
inclusion criteria set for selection were reviewed retrospectively. The outcome
measures were all diagnosed surgical site infections whether superficial or deep,
leg or sternal. Results: One hundred fifty seven patients were included in the retrospective
analysis. All patients (100%) received antibiotic prophylaxis regardless of the
timing while only 38% received it 30-60 minutes prior to incision. Only 12% of
those fitting the criteria for an intraoperative dose did actually receive it. Concerning the duration of prophylaxis, around 15% of patients received up to 5
doses of prophylactic antibiotics post-operatively. The mean number of doses
received was 6 ±0.97 regardless of the antibiotic given. Concerning preoperative
agents given, cefuroxime alone was used in 74.5% of the cases, while
vancomycin alone was common in 5% of cases. The combination of both agents
was common in 7.64% of cases. The rest (11.46%) received no preoperative dose
at all. Postoperatively, the shares of cefuroxime, vancomycin, and their
combination among the population were 91.7%, 3.8%, 2.54% respectively. One
patient received cefazolin pre- and post-operatively. Only 2 patients (1.27%) had
surgical site infections; they were sternal infections occurring in non smoker
elderly male patients undergoing CABO and having no known risk factors for
infections at all. Both received cefuroxime pre and postoperatively for 6 doses but no intraoperative antibiotics although their operations lasted for more than 2
hours each (135 min vs 210 min). The added hospital stay was 3 days for one
patient and 4 days for the other. One patient had a wound cultured and revealed
Pseudomonal growth. Both patients were discharged on antibiotics. Conclusion: Antibiotic prophylaxis in cardiac surgery is a common routine
practiced by doctors at AUB-MC. However, there was a trend towards extended
prophylaxis and excessive use of cefuroxime. The low number of patients
acquiring a surgical site infection (2 patients) at AUB-MC can't allow significant
findings and thus hinders further recommendation concerning the practice.
2011-10-17T09:11:03Z
2011-10-17T09:11:03Z
2004
2011-10-17
2004-03
Thesis
http://hdl.handle.net/10725/792
https://doi.org/10.26756/th.2004.20
en
oai:laur.lau.edu.lb:10725/8332019-09-11T07:02:54Zcom_10725_2058col_10725_2074
Utilization and cost evaluation of tropisetron use for CINV. (c2004)
Abdel-Rahman, Maya O.
Reda, Maya T.
Cancer -- Chemotherapy -- Complications
Antineoplastic agents -- Side effects
Antiemetics -- Therapeutic use
Chemotherapy -- Case studies
Nausea -- Prevention and control
Vomiting -- Prevention and control
Includes bibliographical references (leaves 26-31).
This thesis is a retrospective study on 300 medical records between January 2003 and
June 2003 in Makassed General Hospital (MGH). The objective of this study is to
determine if tropisetron use at MGH was appropriate, and if not, determine possible
interventions for cost savings. The results showed a significant tropisetron overuse,
which can be prevented by targeted interventions like seminars or pre-printed protocols
for both nurses and medical doctors.
2011-10-20T11:34:23Z
2011-10-20T11:34:23Z
2004
2011-10-20
2004-06-28
Thesis
http://hdl.handle.net/10725/833
https://doi.org/10.26756/th.2004.28
en
oai:laur.lau.edu.lb:10725/9992017-09-25T07:08:46Zcom_10725_2058col_10725_2074
Physical & psychological changes associated with controlled Ovarian Hyperstimulation in women undergoing assisted reproductive techniques. (c1999)
Haddad, Rana
Infertility, Female
The clinical use of assisted reproductive techniques nowadays is intimately
dependent on the use of controlled ovarian hyperstimulation. Ovarian
hyperstimulation with Gonadotropin Releasing Hormone analogues (GnRHa)
suppression of endogenous gonadotropin activity, and with Human Menopausal
Gonadotropin (HMG) or FSH monotherapy is commonplace in Vitro Fertilization
Programs (IVF). FSH monotherapy includes purified FSH, highly purified FSH and recombinant FSH. Although the treatment outcome has a significant percentage of success, its process is often a heavy strain on the couples. The objective of the study is to examine the physical and psychological changes associated with controlled ovarian hyperstimulation in women undergoing assisted reproductive techniques. A prospective study will be performed at AUH, Assisted Reproductive Technology Unit. The data will be collected from the charts of the patients who presented to the clinic and have been evaluated to receive the treatment for induction of ovulation. A special questionnaire is designed for the gathering of the data. Results will be withdrawn and evaluated through a special program SPSS with the, assistance of a biostatistician. The patients will be evaluated for the adverse effects associated with the treatment and for the anxiety accompanied by it. Patients
assessment and personal acceptance of the treatment will be also evaluated ...
The study will give us an idea about the physical and psychological changes that
accompany the controlled ovarian hyperstimulation in women undergoing assisted
reproductive techniques.
2011-11-17T11:53:13Z
2011-11-17T11:53:13Z
1999
2011-11-17
1999-07
Thesis
http://hdl.handle.net/10725/999
https://doi.org/10.26756/th.1999.14
en
oai:laur.lau.edu.lb:10725/10032017-09-25T07:08:47Zcom_10725_2058col_10725_2074
The effect of Dopamine Agonists on patients with advanced Parkinson's disease subjected to subthalamic deep brain stimulation. (c2000)
Jabre, Mazen Gerges
Dopamine -- Agonists -- Therapeutic use -- Testing
Parkinson's disease
Parkinson's disease (PO) is a neurodegerative disorder predominantly characterized
by the progressive loss of dopaminergic cells in the substantia nigra pars compacta
(SNPC). Striatal dopamine concentration gets significantly reduced, and clinical
symptoms, especially the motor handicap, prevail. The management of this disease is symptomatic, mainly based on the use of levodopa.
Due to the high incidence of adverse effects associated with its chronic use,
alternative treatments based on the direct-acting dopamine agonists have been used.
Deep brain stimulation has been proposed as an alternative effective treatment for
advanced PO cases disabled by the high incidence of levodopa-induced motor
complications. High frequency stimulation of the subthalamic nucleus (STN HFS) alleviated the
severe motor disabilities associated with PO; however, a postoperative ,
pharmacological strategy has not been established yet. The following study reports
and investigates the efficacy, safety and tolerability of a postoperative therapeutic
approach mainly based on dopamine agonists. We run a pilot, prospective, and open-label study on five patients with severe
idiopathic PO who underwent STN HFS. Their postoperative management mainly
consisted of dopamine agonist, while levodopa was considered as a rescue therapy.
Efficacy, safety and tolerability outcome measures were determined 12 weeks after surgery using the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III),
UPDRS part IV (complications of therapy) and the Hoehn and Yahr staging scale.
Three months after surgery, all patients were effectively maintained on dopamine
agonist-based therapy with an 88% improvement in UPDRS motor subscore (p
<0.01). Dyskinesias, motor fluctuations, and levodopa-equivalent daily dose
requirements decreased by 82.35%,82.14%, and 77%, respectively (p<O.OI). The
mean levodopa dose was reduced by 90% (p < 0.01), while the mean dopamine
agonist dose was increased by 15% from preoperative level. Reported adverse events
were mild and transient. Our preliminary study suggests that STN HFS is a safe and effective approach in the treatment of advanced PD. Postoperative dopamine agonist monotherapy can
potentially be proposed in controlling residual motor disability before adding levodopa.
2011-11-17T12:42:53Z
2011-11-17T12:42:53Z
2000
2011-11-17
2000-06
Thesis
http://hdl.handle.net/10725/1003
https://doi.org/10.26756/th.2000.10
en
oai:laur.lau.edu.lb:10725/14002017-09-25T07:10:07Zcom_10725_2058col_10725_2074
Cytochrome P450 2D6 polymorphism in Lebanon. (c2003)
Saade, Sarita Georges
Cytochrome P-450
Drugs -- Metabolism
Includes bibliographical references (leaves 190-257).
2012-12-05T12:49:07Z
2012-12-05T12:49:07Z
2003
2012-12-05
2003-08-25
Thesis
http://hdl.handle.net/10725/1400
https://doi.org/10.26756/th.2003.13
en
oai:laur.lau.edu.lb:10725/14042017-09-25T07:10:07Zcom_10725_2058col_10725_2074
Evaluation of antibiotic prophylaxis and other factors affecting the incidence of surgical site infection in appendectomy at a tertiary medical center in Lebanon. (c2003)
Hamra, Rasha Saadi
Antibiotics -- Therapeutic use
Medicine, Preventive
Background: Appropriate antibiotic prophylaxis can reduce the incidence of surgical site infections (55I) in many procedures. Its role in acutely inflamed appendicitis remains controversial. Complicated appendicitis is frequently associated with superlative complications. Objectives: The objective is to evaluate the appropriateness of antibiotic prophylaxis in patients undergoing appendectomy at a tertiary care medical center; to assess the antibiotic choice, timing, and duration of administration; and to determine the impact and the value of intraoperative cultures on the selection of antibiotics. Material and Methods: The medical charts of patients with a positive pathology for acute, gangrenous or perforated appendicitis who underwent appendectomy between January l, 1999 and April 30, 2001 at American University of Beirut Medical Center (AUBMC), were retrospectively reviewed. Results: 99% of patients received antibiotic prophylaxis. 37% of cases received their preoperative prophylactic dose at 30-60 minutes before incision. 73% of patients who had acute appendicitis received prophylactic antibiotics for more than 24 hours. The most common regimen used preoperatively was amoxicillin/clavulanic acid while the triple regimen was the most frequently used postoperatively. 7%, of the study population, developed surgical site infection (SSI); all had emergency appendectomy, and 71% received inappropriate preoperative prophylaxis. Other contributing factors to the development of SSI were found to be the pathological state of the appendix, open surgical procedure, and pediatric age group. The mean added hospital stay for patients with SSI was 5 days per patient. 47% received oral antibiotics upon discharge. The most common organism isolated intraoperative was Escherichia coli in 70% of cases followed by Enterococci in 19% and Pseudomonas aeruginosa in 7.5%; no anaerobes were isolated. There was a 5% change in antibiotic regimen following the results of intraoperative cultures. Conclusion: Antibiotic prophylaxis is widely used in appendectomy with tendency towards long courses. It is an effective modality of reducing SS! if applied appropriately. Inappropriate prophylaxis, emergency surgery, open procedures, complicated appendicitis, and pediatric patients are major contributing factors to development of SSI. Intraoperative culture results did not significantly influence antibiotic therapy.
2012-12-06T12:31:40Z
2012-12-06T12:31:40Z
2003
2012-12-06
2003-09-16
Thesis
http://hdl.handle.net/10725/1404
https://doi.org/10.26756/th.2003.14
en
oai:laur.lau.edu.lb:10725/64412021-03-19T10:03:26Zcom_10725_2058col_10725_2074
Coping mechanisms among Lebanese first-time college students
Doumit, Rita
Background: Newly admitted college students are subject to a massive input of
stresses which require successful and ever-changing coping strategies. An expanding
body of literature suggests that inadequate responses to coping with stress in adolescents
of college age contributes to a range of psychosocial problems, including poor academic
performance, anxiety, depression, mental distress and eating disorders. Those problems
may be further exacerbated for adolescents who live in countries plagued by the
uncertainties of war and violence.
Significance: The concept of coping is of particular interest in Lebanon given the
socio-cultural context in which Lebanese youth pursuit their education and social
activities.
Methods: A descriptive correlational cross-sectional design was used to explore
the relationships of stress, uncertainty, resilience, religiosity, socioeconomic status, social
support to coping and well-being in Lebanese newly admitted college students. The
Seiffge-Krenke’s Stress, Coping and Outcomes Model (1995) was used as the conceptual
framework for this descriptive cross-sectional correlational study. A convenient study
sample of 293 newly admitted college students were recruited at the Lebanese American
University on the Beirut campus. Data was gathered from self-reported questionnaires.
Results: Results demonstrated that Lebanese first-time college students used a
combination of internal, active and withdrawal coping strategies as anticipated. Strategies
xiv
used varied with the type of situation. A greater proportion of overall strategies used
included active and internal coping strategies which were focused on resolving the issue
or problem. Stress (r= -.547, p < .01) had the highest correlation with well-being
followed by social support (r= .377, p < .01), resilience (r = .366, p < .01), uncertainty (r=
-.353, p < .01), withdrawal coping (r = -.243, p < .01), and gender (p < .01) as a
controlling variable. When all those factors were combined together, six variables in
addition to gender accounted for significant increments of variance in the level of wellbeing.
These six variables included stress related to self, resilience, uncertainty, social
support, religiosity, withdrawal coping and gender. As scores on resilience, social support
and being male increased, the well-being of Lebanese first-time College students also
increased. As the usage of withdrawal coping strategies, being exposed to stress related to
self and uncertainty increased, the well-being of Lebanese first-time college students
decreased. The final regression model accounted for 54% of the variance in well-being
level (52.7% adjusted) (p < .001). The result of the mediation analysis showed that
coping did not mediate the relationship between stress and well-being.
Implications for Nursing Practice and Research: The results of this study will
provide a better understanding of factors that are predictive of decreased well-being in
Lebanese first-time college students and will be valuable in developing culturally
sensitive intervention of stress and coping management program with a surveillance
system and a systematic planning and evaluation procedure to respond to emerging and
changing students’ needs at the Lebanese American University.
2017-10-30T13:17:42Z
2017-10-30T13:17:42Z
2012
2017-10-30
Thesis
http://hdl.handle.net/10725/6441
Doumit, R. (2012). Coping mechanisms among Lebanese first-time college students (Doctoral dissertation, Loyola University Chicago).
Chicago
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://search.proquest.com/docview/1081486651?pq-origsite=gscholar
en
Loyola University Chicago
oai:laur.lau.edu.lb:10725/68232021-03-19T10:43:11Zcom_10725_2058col_10725_2074
Investigating the mechanism by which the platelet-derived growth factor receptor promotes metastasis in medulloblastoma
AbouAntoun, Thamara Jihad
Expression of the platelet-derived growth factor receptor (PDGFR) correlates with metastatic medulloblastoma and PDGF treatment of medulloblastoma cells activates the pro-survival and pro-migratory pathways downstream of the receptor, for instance, increases extra-cellular regulated kinase (Erk1/2), Protein kinase B (Akt) and phosphatidylinositide 3-kinase (PI3K) activity and decreases phosphatase and tensin homolog (PTEN) expression and activity. PDGFR can also heterodimerize with and transactivate the epidermal growth factor receptor (EGFR). Our overarching hypothesis was to determine whether targeting PDGFR activity effectively inhibits signaling required for medulloblastoma cell migration and invasion and whether it blocks PDGFR-induced transactivation of EGFR. To explore this we used Daoy and D556 human medulloblastoma cells which we transfected with small interfering RNA (siRNA) to PDGFRβ or treated with either Imatinib mesylate (Gleevec®) or Sunitib Malate (SUTENT®), specific inhibitors of PDGFR, to block PDGFR expression and activity, respectively. Cell migration, survival and PDGFR signaling following PDGF-BB stimulation of serum-depleted cells, with and without PDGFR inhibition, was measured. PDGF-BB treatment of cells enhanced migration and proliferation after 24 hr; increased PDGFRβ, PI3K, Akt and Erk1/2 activity, decreased PTEN activation and transactivated EGFR. Imatinib (1 uM) treatment of PDGFRβ active cells induced apoptosis at 72 hr and inhibited migration at 24 hr and invasion at 48 hr after a single dose and concomitantly inhibited PDGF-BB activation of PDGFRβ, PI3K, Akt and Erk1/2 but promoted PTEN activity. SUTENT (0.2 uM) treatment similarly inhibited short (4 hr) and long-term (24 hr) cell migration and cell invasion. PDGF-BB activation of PDGFRβ, PI3K, Akt and Erk1/2 was simultaneously inhibited by SUTENT treatment, while PTEN activity was promoted, without any affect on apoptosis. siRNA silencing of PDGFRβ similarly inhibited survival, migration and signaling and both siRNA and Imatinib or SUTENT treatment inhibited PDGF-BB-induced EGFR trans-activation. Inhibition of PDGFRβ in medulloblastoma cells by siRNA or drug treatment effectively blocked PDGFRβ signaling and EGFR transactivation and concomitantly inhibited cell migration and invasion. These results indicate that PDGFRβ tyrosine kinase activity is critical for survival and migration/invasion of medulloblastoma cells, in part by decreasing PTEN activity and transactivating EGFR, and thus may represent an important therapeutic target for this disease.
2017-12-18T10:23:04Z
2017-12-18T10:23:04Z
2008
2017-12-18
Thesis
http://hdl.handle.net/10725/6823
AbouAntoun, T. J. (2008). Investigating the mechanism by which the platelet-derived growth factor receptor promotes metastasis in medulloblastoma (Doctoral dissertation, The George Washington University).
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://search.proquest.com/docview/193997870?accountid=27870
en
George Washington University
oai:laur.lau.edu.lb:10725/97132021-09-20T10:30:33Zcom_10725_2058col_10725_2074
Alternative energy science and policy
Ammous, Saifedean H.
This dissertation studies the science and policy-making of alternative energy using biofuels as a case study, primarily examining the instruments that can be used to alleviate the impacts of climate change and their relative efficacy. Three case studies of policy-making on biofuels in the European Union, United States of America and Brazil are presented and discussed. It is found that these policies have had large unintended negative consequences and that they relied on Lifecycle Analysis studies that had concluded that increased biofuels production can help meet economic, energy and environmental goals. A close examination of these Lifecycle Analysis studies reveals that their results are not conclusive. Instead of continuing to attempt to find answers from Lifecycle Analyses, this study suggests an alternative approach: formulating policy based on recognition of the ignorance of real fuel costs and pollution. Policies to combat climate change are classified into two distinct approaches: policies that place controls on the fuels responsible for emissions and policies that target the pollutants themselves. A mathematical model is constructed to compare these two approaches and address the central question of this study: In light of an ignorance of the cost and pollution impacts of different fuels, are policies targeting the pollutants themselves preferable to policies targeting the fuels? It is concluded that in situations where the cost and pollution functions of a fuel are unknown, subsidies, mandates and caps on the fuel might result in increased or decreased greenhouse gas emissions; on the other hand, a tax or cap on carbon dioxide results in the largest decrease possible of greenhouse gas emissions. Further, controls on greenhouse gases are shown to provide incentives for the development and advancement of cleaner alternative energy options, whereas controls on the fuels are shown to provide equal incentives to the development of cleaner and dirtier alternative fuels. This asymmetry in outcomes — regardless of actual cost functions — is the reason why controls on greenhouse gases are deemed favorable to direct fuel subsidies and mandates.
2018-11-07T07:57:57Z
2018-11-07T07:57:57Z
2011
2018-11-07
Thesis
http://hdl.handle.net/10725/9713
Ammous, S. H. (2011). Alternative Energy Science and Policy: Biofuels as a Case Study (Doctoral dissertation, Columbia University).
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://papers.ssrn.com/Sol3/papers.cfm?abstract_id=2832730
en
Columbia University
oai:laur.lau.edu.lb:10725/114482021-03-19T10:47:38Zcom_10725_2058col_10725_2074
Impact des pompes d'efflux (abcb1 et abcg2) de la barrière hémato-encéphalique sur le passage cérébral du riluzole et de la minocycline
Milane, Aline
La sclérose latérale amyotrophique (SLA) est une maladie neurodégénérative fatale. Le seul traitement ayant reçu l'AMM est le riluzole (RLZ). La minocycline (MNC) a montré être neuroprotectrice dans un modèle murin de SLA. L'objectif de ce travail a été d'explorer le passage cérébral du RLZ et de la MNC et plus particulièrement les mécanismes d'efflux médiés par les transporteurs ABC: la P-gp et la BCRP. Nous avons aussi exploré l'intéraction médicamenteuse entre RLZ et MNC. Nos essais ont montré que le RLZ et la MNC sont transportés par la P-gp et que le RLZ est aussi transporté par la BCRP. La MNC est inhibitrice de la P-gp et potentialise ainsi le passage intracérébral du RLZ qui lui a montré pouvoir induire la BCRP. Sur un modèle murin de SLA, l'expression cérébrale de la P-gp est induite et les concentrations cérébrales en RLZ sont plus faibles. Ces études devraient, être intégrées en préclinique, quand une association médicamenteuse est envisagée.
2019-10-15T09:02:08Z
2019-10-15T09:02:08Z
2009
2019-10-15
Thesis
http://hdl.handle.net/10725/11448
Milane, A. (2009). Impact des pompes d'efflux (abcb1 et abcg2) de la barrière hémato-encéphalique sur le passage cérébral du riluzole et de la minocycline: application à la sclérose latérale amyotrophique (Doctoral dissertation, Paris 11).
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://www.theses.fr/2009PA114801
fr
pharmacie (Châtenay-Malabry, Hauts-de-Seine)
oai:laur.lau.edu.lb:10725/134442022-07-14T07:48:12Zcom_10725_2058col_10725_2074
The Effect of Genetic Polymorphism on Therapeutic Response of Metformin in Women with Polycystic Ovarian Syndrome in Iraqi Population
Al Shaikhly, Raya
Metformin -- Therapeutic use
Polycystic ovary syndrome -- Treatment
Insulin resistance
Insulin -- Receptors
Women -- Health and hygiene -- Iraq
Lebanese American University -- Dissertations Corporate
Dissertations, Academic
Insulin resistance and compensatory hyperinsulinemia have been proposed as potential mechanisms for the gonadotropin secretory abnormalities characteristic of PCOS. Thus, metformin, an insulin-lowering agents, has been prescribed extensively to regulate insulin level of patients with PCOS. However, there are individual differences in the treatment effectiveness of metformin among PCOS patients. The exact mechanism of insulin resistance remains to be clarified; however, it is supposed that it originates from the post-receptor defects. The insulin receptor substrate-1 (IRS1) is an important intermediate in insulin signaling pathway.
Polymorphisms in IRS1 have been associated with insulin resistance. Respectively, in this study, we investigated the effect of the polymorphisms of IRS1 on the treatment effectiveness of metformin in PCOS patients. The study involved 100 women diagnosed with PCOS according to Rotterdam criteria and 100 control healthy women. All patients diagnosed with PCOS received 500 mg twice daily for 12 weeks. Both case and control group were genotyped for the single nucleotide polymorphisms (SNPs) (rs1801123) of IRS.1.Main outcome measures were hormonal parameters, metabolic parameters, and lipid panel parameters. They were measured at baseline for control and PCOS group and 12 weeks post metformin treatment for PCOS patients only.Our study has shown that metformin had differential effects on fasting insulin level, HbA1C, LH, LH/FSH ratio, testosterone (p-value<0.05)among patients based on different genotypes of IRS.1. Patients with mutated IRS.1 were not showing the same response as patients with intact IRS.1 gene. This finding provides data to support future PCOS clinical trials about Iraqi population, but also shows how genetics and polymorphism can play an important role in explaining how the response of PCOS patients might differ according to a specific type of polymorphism.
2022-04-05T11:32:33Z
2022-04-05T11:32:33Z
2021
2021-01-01
Thesis
http://hdl.handle.net/10725/13444
https://doi.org/10.26756/th.2022.337
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/134452022-07-14T07:44:35Zcom_10725_2058col_10725_2074
The role of corticosteroids in the early management of sepsis in the Lebanese population
El-Ratel, Rayan
Septic shock -- Treatment -- Lebanon
Septicemia -- Treatment -- Lebanon
Corticosterone -- Physiological effect
Lebanese American University -- Dissertations
Dissertations, Academic
The use of corticosteroids in the management of sepsis has been quite controversial. This thesis was motivated by a pursuit to gain a better understanding about the safety and efficacy of using corticosteroids in sepsis. In order to achieve our objective, this thesis will capitalize on an intervention that has been previously implemented in a private hospital in Lebanon. The intervention entailed adding corticosteroids to the management protocol of a group of septic patients. Also to better understand the importance of this intervention, this thesis will specifically compare clinical outcomes of the group of patients who received the intervention (which took place between February 2018 and April 2019), to another group of septic patients admitted prior to the implementation of the intervention (patients admitted between January 2016 and February 2018).
This study is in no way an interventional study, it will build on and analyze a previously conducted intervention in a retrospective manner.
2022-04-05T11:32:50Z
2022-04-05T11:32:50Z
2020
2020-12-25
Thesis
http://hdl.handle.net/10725/13445
https://doi.org/10.26756/th.2022.336
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/134472022-07-14T06:54:33Zcom_10725_2058col_10725_2074
Investigating the Therapeutic Effects of Small Molecule Imipridones In Pediatric Neuroblastoma
El Soussi, Sarra
Neuroblastoma -- Molecular aspects
Neuroblastoma -- Treatment
Cell proliferation -- Drug effects
Lebanese American University -- Dissertations
Dissertations, Academic
The small molecule inducers of TRAIL ONC201/TIC10 and its analog ONC206 exhibit anti-tumor activity by inhibiting AKT/ERK phosphorylation and causing early activation of the integrated stress response. They are reported to inhibit the DRD2 receptors and activate mitochondrial ClpP leading to apoptosis and reduced proliferation in various tumors. Neuroblastoma is the most common extra-cranial nervous system tumor in children that presents with a spectrum of clinical prognostic measures ranging from benign growths that regress spontaneously to highly malignant, treatment evasive tumors affiliated with high mortality rates. MYCN amplification renders this tumor highly malignant and recurrence prone. In our current study we report for the first time, a novel inhibition of EGF-induced L1CAM and PDGFRβ phosphorylation with either ONC201 or ONC206 treatment in human MYCN-amplified neuroblastoma IMR-32 and non-MYCN amplified SK-N-SH cell lines. Drug treatment in these cells significantly reduced cellular proliferation, viability, migration and increased apoptosis. Tumorsphere formation potential was further significantly reduced with either drug treatment in both cell lines with ONC206 exhibiting much higher potency. MYCN expression was significantly abrogated in the IMR-32 cell line with either drug treatment. The protein expression of Sox-2, Oct-4, FABP5 and HMGA1 was significantly reduced whereas cleaved PARP1 and caspase-3 and p-H2AX was increased 48 h after drug treatment in the MYCN-amplified IMR-32 cell line. We are the first to report this novel differential protein expression after ONC201 or ONC206 treatment in these cells. Our findings demonstrate an important multi-target effect of imipridones that may yield added therapeutic benefits in treating this devastating cancer.
2022-04-05T11:33:29Z
2022-04-05T11:33:29Z
2020
2020-11-19
Thesis
http://hdl.handle.net/10725/13447
https://doi.org/10.26756/th.2022.334
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/134532022-07-14T05:50:48Zcom_10725_2058col_10725_2074
The Effect of Formulation Parameters on the Physical Properties and In-Vitro Dissolution Profile of Ethyl Cellulose-Theophylline Microspheres Using the Emulsion-Solvent Evaporation Process
Rammal, Hassan A
Microspheres (Pharmacy)
Drug delivery systems
Microencapsulation
Ethylcellulose
Lebanese American University -- Dissertations
Dissertations, Academic
Controlled-Release drug delivery using microspheres depends on drug-encapsulation formulation, processing conditions, and excipient physical properties. Several parameters affect the microspheres’ formation and properties, including Physical, Chemical, and dissolution profile. This thesis aims to gain a better understanding of the number and type of parameters which affect the properties of Ethyl-Cellulose-Theophylline microspheres, and also attempts to explain the reason why said parameter affects said property in a certain specific way. In order to fully explore by
which means drug-encapsulated microspheres are affected, this thesis looked at eight different parameters which were suspected to trigger changes in the properties of microspheres. The final aim of this thesis was to develop the most effective, efficient, and environmentally friendly method to form microspheres possessing the most beneficial properties for controlled release drug delivery
2022-04-05T12:49:10Z
2022-04-05T12:49:10Z
2020
2020-06-07
Thesis
http://hdl.handle.net/10725/13453
https://doi.org/10.26756/th.2022.329
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/136622023-05-10T09:29:48Zcom_10725_2058col_10725_2074
Anti-cancer Evaluation of Lebanese Cannabis Oil Extract on Lung and Breast Cancer Cells
Saliba, Jane
Lungs -- Cancer -- Molecular aspects
Breast -- Cancer -- Molecular aspects
Cannabis -- Therapeutic use
Cannabis sativa L. is one of the oldest plants used in traditional medicine. Lebanese cannabis is recognized around the world for its quality and recreational use; however, little is known about its medicinal importance. Cannabis is a distinctive plant containing a variety of compounds most notably cannabinoids and terpenoids. Cannabis oil extract (COE) has been shown to possess anti-inflammatory and anticancer activities, which could be attributed to the interaction between terpenes and cannabinoids as “entourage effect”. In this study, we look at the anti-tumorigenic effects of Lebanese COE on non-small cell lung cancer cell line (NSCLC) A549 and the triple negative breast cancer cell line (MDA-MB-231). GC-MS analysis of COE revealed CBD dominance (59.1%) followed by THC (20.2%). Cell viability was evaluated using MTS cell proliferation assay and COE demonstrated more selectivity against MDA-MB-231 (IC50 =26.7 μg/mL) and A549 (IC50 =30.2 μg/mL), compared to rat stem cells (IC50 =42.31 μg/mL). COE caused more significant cell migration inhibition in A549 cells than MDA-MB-231 cells. Western blot analysis showed significant increase in MAPK/ERK pathway and the autophagic marker LC3B. Cell cycle analysis by flow cytometry and western blot assay revealed a minor involvement of apoptosis in cell death. In conclusion, the results confirmed that COE has dose/time dependent effect and is effective in inhibiting cancer cell migration These results necessitate further studies to better understand the complex cell-death mechanisms of COE and provide supportive evidence for its use in cancer treatment.
2022-06-15T05:51:15Z
2022-06-15T05:51:15Z
2021
2021-05-31
Thesis
http://hdl.handle.net/10725/13662
https://doi.org/10.26756/th.2022.250
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/137382023-05-10T09:24:34Zcom_10725_2058col_10725_2074
Evaluation Of Anti Thyroid Activity of Cannabis Sativa Oil Extract Against Levothyroxine Induced Hyperthyroidism in Mice
Al Sayed, Dania
Cannabis -- Therapeutic use
Thyroid antagonists
Thyroid antagonists -- Physiological effect
Lebanese American University -- Dissertations
Dissertations, Academic
Lebanese cannabis is well-known for its high quality and recreational value; yet little is known regarding its medical use. Hyperthyroidism affects approximately 1%-2% of the world population. Limited literature is available on cannabis use on thyroid dysfunction. The present study aims to explore the antithyroid potential of Lebanese cannabis oil extract (COE) use in mice. Male BALB/c mice weighing between 31 and 35 grams were distributed into five groups of 14 mice each; group I served as control and was given a mixture of Ethanol: Cremophor: PBS (1:1:18) administered intra peritoneally (i.p.) for 35 days. To induce hyperthyroidism, group II was given levo- thyroxine (10μg) orally for 35 days; groups III, IV, and V were given levo- thyroxine (10μg) over 14 days and then treated with PTU (0.2mg/kg PO), COE (10mg/kg i.p.), and COE (20mg/kg i.p.), respectively over 21 days. The effect of COE on hyperthyroidism was assessed by measuring FT3, FT4 and TSH levels in mice blood. Mice liver and thyroid morphology was examined, as well. Results show that COE and PTU where equally effective in controlling FT3 levels in mice (P-value <0.001), but PTU was more potent than COE dose I and dose II in abating FT4 levels. Regarding thyroid and liver morphology, the group treated with COE dose II (group V) showed the lowest thyroid weight as compared to other treated groups (III, IV). To note, there was no observed difference in the liver morphology in any of the treated and control groups. In conclusion, the results assured that COE has dose/time dependent effect in lowering FT3 and FT4 thyroid hormones. Further studies are required to acknowledge the mechanism of action of COE antithyroid effect.
2022-06-22T08:27:41Z
2022-06-22T08:27:41Z
2021
2021-12-14
Thesis
http://hdl.handle.net/10725/13738
https://doi.org/10.26756/th.2023.573
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/137472022-06-30T05:44:45Zcom_10725_2058col_10725_2074
Efficacy and Toxicity of Hand Sanitizers
Zgheib, Rebecca
Hand -- Care and hygiene
Hand washing
Antiseptics
COVID-19 (Disease) -- Prevention
Lebanese American University -- Dissertations
Dissertations, Academic
Since the outbreak of Coronavirus Disease 2019 (CoVID-19), the World Health Organization has suggested that alcohol-based hand sanitizers should be used in the absence of soap and water to prevent the spread of SARS-CoV2.
This study aimed to assess the efficacy and toxicity of hand sanitizers produced and/or distributed on the Lebanese market. The study included 31 different brands of hand sanitizers that were analyzed using headspace gas chromatography- mass spectrometry to detect impurities and alcohol content. The impurities were identified based on a Mass Spectrometry database. Regression analysis was used to determine ethanol percentage.
Accordingly, a toxicological review was conducted to assess the various risks associated with the usage of hand sanitizers.
Detected impurities mainly included but not limited to ethyl acetate, benzene, acetone, and acetal.
Among the ethanol-containing hand sanitizers, 71% contained less than 60% v/v alcohol not complying with the CDC and WHO recommendations which state that ethanol concentration should be at least 60%. Isobutanol and other non-recommended alcohols (methanol and 1-propanol) were also detected as contaminations.
Consumers should be aware that some hand sanitizers available on the Lebanese market are ineffective and include residues of harmful substances.
2022-06-22T09:29:00Z
2022-06-22T09:29:00Z
2022
2022-01-14
Thesis
http://hdl.handle.net/10725/13747
https://doi.org/10.26756/th.2022.179
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/137482022-06-22T09:31:53Zcom_10725_2058col_10725_2074
Detection of Impurities in Acetaminophen Intravenous and Oral Formulations Available on the Lebanese Market
Rahme, Rita
Acetaminophen -- Toxicology
Environmental chemistry
Chromatographic analysis
Lebanese American University -- Dissertations
Dissertations, Academic
Introduction: The presence of impurities in pharmaceutical formulations has been a concern worldwide. Acetaminophen is a commonly used drug for its analgesic and antipyretic properties. We report here a novel method for the impurity profiling of intravenous acetaminophen formulations by head space gas chromatography. In addition, impurity profiling of oral acetaminophen tablets and capsules available on the Lebanese market and manufactured in Lebanon was not reported, as well.
Objective: The purpose of this study is to detect impurities present in intravenous and oral samples of acetaminophen on the Lebanese market and analyze the risks that these impurities pose to human health.
Methods: static headspace gas chromatography- mass spectrometry was utilized as one of the most suitable methods to detect organic volatile impurities. Samples for intravenous use where first lyophilized prior to analysis. A total of 25 samples were analyzed: 9 and 16 for intravenous and oral use, respectively. Toxicological review was performed on the detected impurities and the different risks associated were analyzed.
Results: of the 9 intravenous samples analyzed, 6 contained impurities. As for the oral samples, 9 out of 16 samples contained impurities. A total of 14 different impurities were detected: acetaldehyde, cyclomethicone 5, cyclomethicone 6, dibutyl phthalate, diethyl phthalate, diacetamate, ethanol, ethyl stearate, formic acid, glycidol, methyl carbamate, methyl hydrazine, methyl stearate, and triethylamine. Several of the detected impurities are highly nephrotoxic, hepatotoxic, neurotoxic, carcinogenic, and/or teratogenic.
Conclusion: In view of the toxicity of the detected impurities and the negative impact they carry on the quality of the formulation as well as on human health, it is of utmost importance for the concerned pharmaceutical industries to take appropriate measures to control the source of these impurities and abide by the guidelines set by the regulatory authorities all around the world. Regulatory authorities should also take the necessary measures to preserve the safety of treated patients.
2022-06-22T09:31:53Z
2022-06-22T09:31:53Z
2022
2022-01-27
Thesis
http://hdl.handle.net/10725/13748
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/136372022-07-07T06:22:53Zcom_10725_2058col_10725_2074
Development and Characterization of Mucoadhesive Thin Film as an Oral Mucosal Drug Delivery System of Carbinoxamine Maleate
El Hajj, Antonio
Thin films
Drug delivery systems
Polymeric drugs
Lebanese American University -- Dissertations
Dissertations, Academic
Objective: Thin film (TF) is an oral mucosal drug delivery system that disintegrates and dissolves the drug rapidly when placed on any oral mucosal tissue. This work aimed to develop and characterize TF containing carbinoxamine maleate (CM) for the symptomatic treatment of seasonal and perennial allergies and other allergic conditions.
Methods: Three optimized batches were developed by solvent-casting method with different ratios of blends of hydroxypropyl methylcellulose (HPMC) E50LV and polyvinylpyrrolidone (PVP) K12 or K85-95 as mucoadhesive film-forming polymers. The produced TFs were subjected to physicochemical and mechanical characterization.
Results: The weight and thickness of TF were in the range of 40.47 mg ± 0.49 to 65.70 mg ± 1.51 and 50.80 μm ± 1.11 to 95.20 μm ± 2.50, respectively. The percent drug load was found to be within the acceptable limit for content uniformity. Within 15 minutes, the amount of CM released from thin films of Batch 3 was 81.04% ± 1.91 which was significantly slower than Batch 1 and Batch 2. The disintegration of TFs was achieved in less than 180 seconds. Results of mechanical testing revealed high values of Young’s modulus with no significant difference between batches. The incorporation of blends of HPMC E50 LV and PVP K85-95 at a ratio of 1:1 notably decreased tensile strength and elongation at break.
Conclusion: This work demonstrates the successful development of TF as an adequate delivery system for the administration of CM. The selection of the film-forming polymer type, grade, and ratio can impact the characteristics of the TF and modify the delivery of CM.
Keywords: Mucoadhesive Polymers, Thin Film, Drug Delivery, Carbinoxamine Maleate.
2022-06-13T08:57:28Z
2022-06-13T08:57:28Z
2021
2021-08-02
Thesis
http://hdl.handle.net/10725/13637
https://doi.org/10.26756/th.2022.270
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/136492022-07-06T10:58:54Zcom_10725_2058col_10725_2074
Investigating The Efficacy of Ruxolitinib and CHIR-99021 in Targeting Pediatric Neuroblastoma Stem Cells
Al Sayyed, Fatima
Neuroblastoma -- Treatment
Stem cells -- Therapeutic use
Chemotherapy
Lebanese American University -- Dissertations
Dissertations, Academic
Neuroblastoma is the most common malignant tumor of infancy and accounts for 10% of all childhood cancers. The high biological and clinical heterogeneity of this tumor leads to differences in clinical outcomes ranging from benign tumors that regress spontaneously to metastatic tumors that are ultimately fatal. Despite the recent advances, many children continue to suffer from refractory and relapsed diseases, and they often develop metastatic tumors resistant to standard treatments. Amplification of MYC-N proto-oncogene is highly associated with clinically aggressive disease, recurrence and treatment failure. The highly malignant rate in neuroblastoma is likely due to the continuous acquisition of genetic aberrations in undifferentiated neuroblastoma cancer stem cells (CSCs). CSCs play a crucial role in dysregulating different pathways that are involved in metastasis, invasion, angiogenic properties, uncontrolled proliferation, self-renewal capacities and therapeutic resistance. In this study, we investigate the efficacy of two small molecules Ruxolitinib, a JAK/STAT inhibitor, and CHIR-99021, a GSK-3 inhibitor, in targeting pediatric neuroblastoma stem cells by testing them on human MYC-N amplified, IMR-32, and non-MYC-N amplified, SK-N-SH, cell lines. Treating neuroblastoma cells with Ruxolitinib and CHIR-99021 resulted in significant reduction in cellular proliferation, viability, apoptosis and tumorsphere formation capacity in both IMR-32 and SK-N-SH cell lines. Western blot analysis showed significant decrease in stem cell markers SOX-2 and Oct-4, and tumorigenic protein HMGA1, whereas it showed significant increase in apoptotic markers cleaved PARP and cleaved caspase-3. In conclusion, our findings demonstrated that Ruxolitinib and CHIR-99021 could be promising therapies in targeting neuroblastoma CSCs, and that combining these two drugs may have added therapeutic effects in treating this malignant tumor. Further studies are warranted to elucidate the therapeutic mechanism through which these drugs act to target the various tumorigenic pathways.
2022-06-14T06:34:18Z
2022-06-14T06:34:18Z
2021
2021-08-04
Thesis
http://hdl.handle.net/10725/13649
https://doi.org/10.26756/th.2022.262
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/137262022-06-30T08:48:49Zcom_10725_2058col_10725_2074
The Protective Effects of Daucus carota L. ssp. carota and Cannabis sativa L. Extracts against Cisplatin Induced Nephrotoxicity in Animal Models
Al Toufaily, Sahar
Carrots -- Therapeutic use
Cannabis -- Therapeutic use
Nephrotoxicology -- Animal models
Cisplatin
Lebanese American University -- Dissertations
Dissertations, Academic
Cisplatin is a standard antineoplastic drug that has been incorporated in many firstline chemotherapy regimens for the treatment of solid tumors such as, advanced ovarian, lung, head and neck, testicular and bladder. However, its use is associated with dose dependent nephrotoxicity, and ongoing attempts have been made to reduce the cisplatininduced
nephrotoxicity. The current study investigates the nephroprotective effects of two native Lebanese plants, Daucus carota and Cannabis sativa, in animal models. Previous studies in our laboratory showed that Daucus carota oil extract (DCOE) possesses antioxidant, anti-inflammatory, and anticancer properties. The major component of DCOE, β-2-himachalen-6-ol (HC), has been isolated and found to be a potential safe and potent chemotherapeutic agent. Additional recent studies showed that Cannabis sativa oil extract (COE) demonstrated potent anti-inflammatory effects.
DCOE (100 mg/kg body weight) and HC (25 and 50 mg/kg body weight) were administered daily to rats for 10 days, and a single dose of cisplatin (7.5 mg/kg body weight) was administered on day five. In another protocol, 2.5, 5, 10, and 20 mg/kg body weight of COE were given daily to mice for three days, and cisplatin (20 mg/kg body weight) was administered on day one. Serum creatinine and urea, proteinuria, and
inflammatory markers were measured. All used doses of COE showed significant decrease in serum urea; however, a significant decrease in serum creatinine was observed only at 20 mg/kg COE. On the other hand, treatment with HC (50 mg/kg) or DCOE (100mg/kg) demonstrated significant decrease in serum urea, but little or no effects was observed on serum creatinine. In addition, COE treatment caused a significant decrease in urinary albumin excretion. Furthermore, Western blot analysis with the antibodies against COX-2 was significantly lower in cisplatin-intoxicated mice with COE in comparison to mice treated with cisplatin alone. In conclusion, the current findings demonstrates that doses of HC (50 mg/kg) and DCOE (100 mg/kg), and all used doses of COE could be a promising approach to protect against cisplatin-induced nephrotoxicity, partially by
ameliorating inflammatory response.
2022-06-17T06:47:39Z
2022-06-17T06:47:39Z
2021
2021-07-30
Thesis
http://hdl.handle.net/10725/13726
https://doi.org/10.26756/th.2022.190
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/138892023-11-08T10:42:51Zcom_10725_2058col_10725_2074
Efficacy of Cannabidiol Combination with Cisplatin or Paclitaxel against Platinum-Resistant Ovarian Cancer Cell Lines
Ismail, Jana
Cannabis -- Therapeutic use
Ovaries -- Cancer -- Treatment
Cisplatin
Platinum compounds -- Therapeutic use
Lebanese American University -- Dissertations
Dissertations, Academic
Cannabidiol (CBD) is one of the most abundant and commonly used cannabinoid of the Cannabis plant. Unlike tetrahydrocannabinol (THC), it lacks psychoactive properties, and thus it is considered to be a uniquely attractive cannabinoid for study. It has been used to treat various ailments, including epilepsy, anxiety, psychosis, inflammation, and cancer. Various in vitro, and to a lesser extent in vivo, studies have demonstrated the anti-cancer activity of CBD on different cancer cell types, and a few others showed that combining CBD with different chemotherapeutic agents exhibited variable interactions, ranging from antagonism, additive effect, and synergism. Few studies examined the anticancer activity of CBD, as well as its combination with cisplatin or paclitaxel, on ovarian cancer. Hence, the current study aimed to evaluate the anti-cancer activity of CBD, extracted from Lebanese Cannabis sativa plant, as monotherapy and in combination with conventional chemotherapeutic drugs cisplatin or paclitaxel on human ovarian adenocarcinoma OVCAR-3 and SK-OV-3 cell lines. CBD was extracted by Liquid Column Chromatography and confirmed by GC-MS. Cell survival was evaluated using the MTS cell proliferation assay. Monotherapy with CBD demonstrated a dose-dependent tumor growth inhibition at 72h, with the IC50 being 12.5 μg/ml for OVCAR-3 cell line and 12.3 μg/ml for SK-OV-3 cell line. The IC50 of cisplatin against OVCAR-3 and SK-OV-3 cell lines (1.1 and 3.3 μg/ml, respectively), and that of paclitaxel against SK-OV-3 cell line (9.9 μg/ml) were obtained as well. Additionally, applying the Chou-Talalay method using the CompuSyn software, the combination indexes (CI) were calculated to predict the interaction between CBD and the chemotherapeutic agents. The combination of CBD with either cisplatin or paclitaxel exhibited a significant antagonistic interaction against SK-OV-3 cell line when compared to individual treatment (CI > 1). However, at high cell growth inhibition rates (95% and 97%), mild synergism is detected (CI < 1) when combining CBD with cisplatin against this specific cell line. Thus, according to Drug Reduction Index (DRI), a combination of 6-fold less concentration of cisplatin with 1.3-fold less concentration of CBD yields a 95% cell growth inhibition. This synergistic interaction was confirmed in an in vitro experimentation setting. Pure antagonism was detected however when combining CBD and cisplatin against OVCAR-3 cell line. Evaluating the effect of CBD combined with paclitaxel against SK-OV-3 cell line demonstrated antagonism on all relevant inhibitory effect levels. Nonetheless, priming SK-OV-3 cells with CBD for 24h to sensitize them to the effect of cisplatin or paclitaxel treatment has shown to decrease the IC50 of the chemotherapeutic drugs. Similar results were revealed when the cells were primed with cisplatin or paclitaxel prior to be treated with CBD. The results suggest the potential benefit of sequential, rather than simultaneous, administration of CBD and chemotherapy to enhance therapy and overcome resistance. These findings, while demonstrating the potential benefit of CBD in treating ovarian cancer, call for additional caution when combining it with chemotherapeutic agents, specifically cisplatin and paclitaxel, as the effect is shown to be cell line and drug specific. Further studies are required for the validation of the results and better understanding of these interactions.
2022-07-28T05:51:08Z
2022-07-28T05:51:08Z
2022
2022-05-13
Thesis
http://hdl.handle.net/10725/13889
https://doi.org/10.26756/th.2022.401
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/139452022-08-23T06:12:15Zcom_10725_2058col_10725_2074
Barriers to the Implementation of a Unique Identifier and a Track and Trace System in the Lebanese Pharmaceutical Sector
Rached, Stephanie
Pharmaceutical industry -- Standards -- Lebanon
Product counterfeiting -- Lebanon
Drugs -- Marketing -- Lebanon
Pharmaceutical ethics -- Lebanon
Lebanese American University -- Dissertations
Dissertations, Academic
Globalization of the pharmaceutical supply chain introduced many new challenges requiring innovative technologies to ensure patients’ access to safe and effective medicine. Adding a unique identifier and implementing a track and trace system on pharmaceuticals allow the traceability of products across the supply chain, ensuring quality by reducing counterfeit products, facilitating the recall process, increasing transparency and on the long run speeding up the reimbursement process by third party payers. There are several barriers preventing the implementation of the track and trace system in Lebanon. The aim of this operational research is to identify these barriers in local pharmaceutical institutions mainly local manufacturers and pharmacies; and providing recommendations to policymakers. Through a three-steps operational research, data was collected from local manufacturers through structured or semi-structured interviews, data was also collected form a purposive sample of pharmacies
through focus groups and interviews, and finally key informants and policy makers were interviewed for a presentation of results and providing recommendations. Descriptive statistics were used to analyze quantitative results, while thematic analysis was used for qualitative data followed by exploratory data analysis. Different themes were identified for the barriers to implementation: financial, logistic, regulatory, internal planning/human resources and infrastructure issues/context specific.
2022-08-17T08:36:14Z
2022-08-17T08:36:14Z
2022
2022-05-23
Thesis
http://hdl.handle.net/10725/13945
https://doi.org/10.26756/th.2022.427
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/142022022-11-02T10:46:28Zcom_10725_2058col_10725_2074
Potential Therapeutic Effects of Lebanese Cannabis oil in Female Mouse Models of Neuropsychiatric Disorders
Hatoum, Fatina
Cannabis -- Therapeutic use
Cannabinoids -- Physiological effect
Neurobehavioral disorders -- Treatment
Depression, Mental -- Treatment
Lebanese American University -- Dissertations
Dissertations, Academic
The Cannabis plant is the most versatile herbal remedy used for the treatment of various medical conditions, including pain, epilepsy, depression, anxiety, and post-traumatic stress disorder. Stress is a normal part of life, and stress responses can vary in different people. Stress-susceptible individuals become prone to depression, while resilient individuals lead a normal life. Limited literature is available about the pharmacological effects of Lebanese Cannabis oil on depression and anxiety disorders. Accordingly, the current research study examined the therapeutic effects of Cannabis oil extracted from the Lebanese Cannabis sativa plant on resilience to stress and its ability to rescue depression and anxiety-like behaviors in female animal models. Pre-treatment and post-treatment protocols were carried out using Cannabis oil to evaluate its anti-depressive effects. In the pre-treatment protocol, female C57BL/6 mice received daily injections of Cannabis oil (5 mg/kg and 20 mg/kg) for five days before and during the induction of depression-like behavior by using several types of stressors for nine days. At the end of the stress paradigm, the animal behavioral was assessed using the social interaction (SI) test. In the post-treatment protocol, female C57BL/6 mice were subjected to daily Chronic Variable Stress (CVS) for nine days. On day 10, the behavior of the mice was assessed using the SI test and animals were divided into susceptible or resilient to stress. Only animals that were classified as susceptible to stress received vehicle or Lebanese Cannabis oil i.p injection treatment (doses of 5 mg/kg and 20 mg/kg). The results showed that intraperitoneal injections of Lebanese Cannabis oil at doses of 5 mg/kg and 20 mg/kg rescued depression-like behaviors induced by the CVS. Therefore, Cannabis oil significantly rescues social avoidance behavior and promotes social interaction. These promising findings call for additional studies to gain a better understanding of the potential effect of Lebanese Cannabis oil on stress and anxiety disorders by studying the effects of whole plant or its major phytocannabinoids, Cannabidiol (CBD) and/or tetrahydrocannabinol (THC).
2022-11-02T10:45:54Z
2022-11-02T10:45:54Z
2022
2022-07-14
Thesis
http://hdl.handle.net/10725/14202
https://doi.org/10.26756/th.2022.506
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/145602023-11-09T10:32:43Zcom_10725_2058col_10725_2074
Novel Natural Based Chewable Lozenges for the Treatment of Erectile Dysfunction
Frem, Jean-Pierre
Impotence -- Treatment
Drugs -- Physiological effect
Pharmaceutical chemistry
Drugs -- Side effects
Lebanese American University -- Dissertations
Dissertations, Academic
Chewable lozenges are easy to use, and highly flavored oral dosage forms used to deliver active ingredients, while providing high patient compliance rates. This work targets the development of chewable lozenges containing multiple natural active ingredients for the treatment of erectile dysfunction. Five batches were developed and analyzed consecutively by adjusting specific processes and material parameters such as the compounding procedure, and excipient quantities based on the physical appearance, stickiness, texture, chewiness, and taste of the lozenges. The most optimal batch obtained is batch “5” and includes adjustments to the compounding procedure to prepare the gelatin base separately while maintaining a heating temperature of 65-70˚C and a mixing speed of 750 rpm and maintaining a lower temperature of 50-60˚C with a mixing speed of 500 rpm while adding the active ingredients. Adjustments of the total liquid content was made to obtain a volume of 1.55 ml/lozenge and a water content of 0.30 ml/lozenge. In addition, the rotary evaporation technique was implemented to remove 6.7 ml (55.83%) of ethanol from the Black Maca liquid extract. Among other adjustments, these were the most significant in impacting the physical parameters and more specifically the stickiness of the lozenges. This project illustrates the successful development of chewable lozenges as a dosage form for the delivery of multiple active natural ingredients with distinct mechanisms of action. Water and solvent contents like ethanol, and process parameters can impact the physical characteristics of the chewable lozenges.
2023-03-14T06:58:44Z
2023-03-14T06:58:44Z
2022
2022-12-30
Thesis
http://hdl.handle.net/10725/14560
https://doi.org/10.26756/th.2022.517
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/146022023-11-08T11:16:35Zcom_10725_2058col_10725_2074
Identification and Characterization of a Novel Bacterial Species Found in the Lebanese Soil
Kyprianos, Shirine
Soil microbiology -- Lebanon
Microbial sensitivity tests
Soils -- Environmental aspects -- Case studies
Lebanese American University -- Dissertations
Dissertations, Academic
The disruption of the soil's ecosystem causes a disturbance in microbial communities and leads to the emergence of dangerous resistant pathogens and most antibiotic resistance genes. An unknown bacterial strain was collected from a mushroom compost in the Lebanese soil as part of another project aiming to identify bacteria capable of being used in bio-cementation. Our study aims to identify and characterize the unknown strain, its features, behavior, and infectious potential. Standardized techniques were used to determine the morphology and staining properties of the bacteria, biochemical and physiological reactions, and susceptibility and resistance to different antimicrobial agents. Since the strain originated from a mushroom compost in the soil, potassium hydroxide ruled out fungal entities. The bacteria are Gram-negative, rod-shaped, obligate aerobes, non-spore forming and non-encapsulated, urease, coagulase, and catalase-positive, oxidase-negative, possessing β-hemolytic activity, and resistant to UV light. The bacterial strain did not form biofilms at the air liquid interface and produced calcium carbonate precipitates. Antimicrobial susceptibility tests were carried out using antibiotics of major classes and Cannabidiol (CBD) oil. The strain conferred resistance to azithromycin, doxycycline, and trimethoprim-sulfamethoxazole. CBD demonstrated bactericidal activity at low doses but did not have an effect at higher concentrations. Based on the results obtained, we determined that the strain belonged to the genus Gluconacetobacter.
All in all, these findings provide preliminary results related to the potential virulence of the bacterial species and its resistance to different antimicrobials. Future in vivo studies are required to determine the infectivity spectrum of the bacteria. Whole genome sequencing is also essential to detect and analyze resistance genes, virulence factors, and
clusters for the production of bio-cement.
2023-03-20T09:41:22Z
2023-03-20T09:41:22Z
2022
2022-12-30
Thesis
http://hdl.handle.net/10725/14602
https://doi.org/10.26756/th.2022.536
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/150902023-11-08T10:44:52Zcom_10725_2058col_10725_2074
Efficacy of Lebanese Cannabis Oil Extract in the Treatment of Folic Acid-Induced Renal Fibrosis in Rats
Bylan, Diana
Kidneys -- Diseases
Cannabis -- Therapeutic use
Cannabinoids -- Physiological effect
Nephrotoxicology -- Animal models
Lebanese American University -- Dissertations
Dissertations, Academic
Kidney disease is a main contributor to mortality and morbidity worldwide. Renal fibrosis is the most common and final manifestation of chronic kidney disease. To date, there are no medications that target kidney cells or kidney fibrosis. The aim of this study is to evaluate the effect of Cannabis oil extract in the management of renal fibrosis in Folic acid-induced renal injury model in Sprague Dawley rats. Folic acid is known to accumulate easily in large amounts in the kidney at the proximal tubule segment when compared to other tissues due to the high content of its receptors in the kidneys. Folic acid was administered as a single dose of 250 mg/kg to induce nephrotoxicity in rats. Cannabis oil extract was administered at increasing doses of 5, 10, or 20 mg/kg to the Folic acid-treated groups for 2 weeks. Another group of rats was given 20mg/Kg Cannabis oil for 5 days followed by Folic acid administration on day 6. Body weight of rats were monitored during the study, serum creatinine, urea, and electrolytes were measured as well as pathological examination of the kidney and heart. Rats that were injected with Folic acid showed a marked reduction in body weight and increase in serum creatinine in comparison to the control group. Treatment with 20mg/Kg Cannabis oil caused a significant increase in body weight compared to the Folic acid treated group. In addition, a significant decrease in serum creatinine was observed in groups receiving cannabis extract at the doses of 5 and 10 mg/kg. Serum sodium was significantly reduced in all the groups receiving Cannabis oil extract. Cannabis oil ameliorated renal and cardiac pathology abnormalities induced by Folic acid in a dose dependent manner. In conclusion, the current results reveal a potential therapeutic and protective effect of Cannabis oil extract in renal fibrosis.
2023-10-20T09:44:54Z
2023-10-20T09:44:54Z
2023
2023-05-18
Thesis
http://hdl.handle.net/10725/15090
https://doi.org/10.26756/th.2023.591
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/151372023-11-09T10:40:42Zcom_10725_2058col_10725_2074
The Role of DJ-1 in the Glycation Process of Skin and Plasma Proteins in Mice Models
Abou Younes, Nour
Proteins -- Research -- Methodology
Proteins -- Analysis
Glycosylation
Skin absorption
Lebanese American University -- Dissertations
Dissertations, Academic
The glycation reaction is a non-enzymatic reaction characterized by and spontaneous binding of sugar molecules and protein. This study focuses on the glycation process at the level of proteins. Protein glycation is initiated by a condensation reaction between the carbonyl of a reducing sugar with the amino or thiol group of a protein. Advanced glycation
end products (AGEs) are the byproduct of the glycation reaction. At the level of the proteins, AGEs are glycated cross-linked proteins that aggregate with time and lose their function. Glycation was classified as an irreversible one-way reaction until the preexisting DJ-1 chaperone protein was identified as a deglycase protein. Since DJ-1 is a highly
conserved protein a DJ-1-derived protein called ND-13 was developed and presented agonistic activity to DJ-1. This study aims to investigate the role of DJ-1 in the glycation process of skin and plasma proteins in mice models to better understand the mechanism of action of DJ-1. AGEs formation was induced in mice models by either passive exposure to
smoke and/or intraperitoneal D-ribose injection. Mice were then treated with ND-13 to identify through it the deglycase activity of DJ-1.Overall, the findings of this study indicate that the glycation process in the skin might need more than just a few weeks to form the early and intermediate glycation products, this was translated by the significant increase of
DJ-1 levels after 8 weeks of treatment with an exogenous glycating agent compared to week 4. In comparison to the other groups, the group treated with ND-13 presented much higher levels of DJ-1 which suggest that ND-13 might present an additive agonistic effect to the endogenous deglycase DJ-1.In contrast, levels of DJ-1 were not detected at the level
of the plasma, this might contribute by further demonstrating that DJ-1 might be an intracellular protein that under oxidative stress translocate into the nucleus or is excreted into the extracellular matrix of the tissue to protect act as an antioxidant and delicate protein to protect both environments. Therefore, our findings propose that DJ-1 might be
upregulated by a significant increase in carbonyl stress in a time dependent manner, further contributing to the preexisting literature about the deglycase activity of DJ-1. However, more perspective studies are needed to identify tissue-specificity of DJ-1 protein.
2023-10-24T09:25:31Z
2023-10-24T09:25:31Z
2023
2023-05-18
Thesis
http://hdl.handle.net/10725/15137
https://doi.org/10.26756/th.2023.622
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/151602023-11-09T08:47:51Zcom_10725_2058col_10725_2074
Therapeutic Effect of Lebanese Cannabis Oil Extract in the Management of Sodium Orthovanadate-Induced Nephrotoxicity in Rats
Habchy, Chistabel
Kidneys -- Diseases -- Case studies
Cannabis -- Therapeutic use
Cannabinoids -- Physiological effect
Nephrotoxicology -- Animal models
Lebanese American University -- Dissertations
Dissertations, Academic
The current study investigated the therapeutic effect of Lebanese Cannabis oil extract against Sodium orthovanadate-induced nephrotoxicity. Sodium orthovanadate is a non-selective inhibitor of protein tyrosine phosphatases that are known to play major modulator roles in cell signaling and survival. Kidney is a major target for the toxicity of Sodium orthovanadate causing several types of renal injury, including glomerulosclerosis, inflammation and tubular damage. The effect of Cannabis oil on Sodium orthovanadate-induced nephrotoxicity was studied in vivo using Sprague Dawley male rat model. Rats were intraperitoneally injected with 10mg/Kg Sodium orthovanadate for 10 days followed by 5mg/Kg, 10mg/Kg, or 20mg/Kg intraperitoneal injection of Cannabis oil extract starting day 4 till day 10. Body weight of rats were monitored during the study and clinical parameters including serum urea, creatinine, and electrolytes were measured as well as kidney and heart pathology. Rats that were injected with Sodium orthovanadate displayed a marked reduction in body weight, increase in serum creatinine and urea in comparison to the control group. All doses of Cannabis oil caused significant decrease in serum urea, as well as in serum creatinine at a dose of 20mg/Kg. In addition, a marked reduction in renal vascular dilatation, scattered foci of acute tubular necrosis, and numerous mitosis in tubular cells was observed in Cannabis oil treated rats (20mg/Kg) as compared to the Sodium orthovanadate- treated group. In conclusion, the primary findings demonstrate a potential therapeutic effect of Cannabis oil on kidney damage induced by Sodium orthovanadate.
2023-11-01T09:55:01Z
2023-11-01T09:55:01Z
2023
2023-05-23
Thesis
http://hdl.handle.net/10725/15160
https://doi.org/10.26756/th.2023.630
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/152852024-01-23T07:20:00Zcom_10725_2058col_10725_2074
Efficacy And Safety of Cannabidiol on Juvenile Diabetes Outcomes in Male Rats
Awkar, Nai
Diabetes in children--Treatment
Cannabis--Therapeutic use
Lebanese American University--Dissertations
Dissertations, Academic
Background: Cannabidiol (CBD) is a major non-psychotomimetic cannabinoid found in the Cannabis sativa plant with several pharmacological effects. Juvenile Diabetes is a major chronic illness that affects the life of patients. CBD presents desirable effects on hyperglycemia by protecting against oxidative stress and inflammation, having neuroprotective properties, and acting on receptors linked to glycemia. Thus, CBD has the potential to decrease HbA1C in diabetic patients (Diabetes Mellitus type 1) and improve their lives.
Objective: The current research aims to explore the pharmacological effect of CBD on Juvenile Diabetes in rat models, as well as the safety profile of CBD including toxicology studies on the liver and the pancreas.
Methods: The research was done by conducting experiments on young adult male Wistar rats. The rats were given streptozotocin (STZ) for Juvenile Diabetes induction. The rats were randomly assigned to four experiments for a total duration of 30 days. Each experiment contained a vehicle control group alongside several groups of different dosage regimens of CBD. Each Experiment consisted of a specific and required number of animals (according to the standardized toxicity tests for rodents).
Results: The animal data and findings from this study offer the opportunity for a safe and effective oral drug for the treatment of Juvenile Diabetes to be considered for further research and clinical trials.
Conclusion: The animal data from this study confirmed the safety of CBD when administered in different dosing regimens per body weight with NOAEL (the no-observed-adverse-effect level) = 150mg/kg. In addition, the results gave promising insights for considering CBD as an oral treatment option for juvenile diabetes as dose-dependent. The CBD dose of 50mg/kg when administered for 14 days was able to control blood glycemia values, body weights and produce insulin concentration levels that are close to normal values.
2024-01-23T07:20:00Z
2024-01-23T07:20:00Z
2023
2023-07-27
Thesis
http://hdl.handle.net/10725/15285
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/152892024-01-23T09:05:09Zcom_10725_2058col_10725_2074
Anticancer Effects of Lebanese Cannabis Oil Against in vivo and in vitro Models of Squamous Cell Carcinoma
Azar Atallah, Shirine
Squamous cell carcinoma--Treatment
Cannabis--Therapeutic use
Cannabis--Therapeutic use--Lebanon
Lebanese American University--Dissertations
Dissertations, Academic
Cannabis sativa L. has a long history of use in traditional medicine for various ailments as an analgesic, anticonvulsant, hypnotic, tranquilizer, and anti-inflammatory agent. Emerging evidence in preclinical studies has also demonstrated the anticancer effect of cannabinoids, which are the major components of the plant. Recent findings established the importance of the endocannabinoid system (ECS) in the maintenance of skin homeostasis. Hence, the current study aims to investigate the potential chemotherapeutic effects of Lebanese Cannabis sativa oil extract (COE) on in vivo and in vitro squamous cell carcinoma (SCC) models, and to determine its underlying mechanism of action. GCMS analysis of COE revealed the presence of two major cannabinoids, CBD (59.1%) and THC (20.2%). Cell proliferation assay (MTS) of COE-treated tumorigenic human epidermal keratinocytes (HaCaT-ras) showed a significant dose and time dependent cytotoxicity with IC50 of 19, 11 and 8 𝜇g/mL at 24, 48 and 72 hours, respectively. Flow cytometry on COE-treated HaCaT cells demonstrated an induction of apoptotic cell death. Western blot analysis confirmed the involvement of apoptosis via both the extrinsic and intrinsic pathways and implicated an additional alteration in autophagy. Reactive oxygen species (ROS) detection assay did not show a significant involvement of oxidative stress in the cytotoxicity of COE. The anti-tumor effect of COE was also evaluated using a DMBA/TPA skin carcinogenesis mouse model. Intraperitoneal treatment of mice with COE (10, 25 or 50 mg/kg; 9 weeks) showed a non-significant decrease in tumor volume with respect to control, without adverse effects on liver and kidney function. In conclusion, COE displayed a promising anticancer activity against SCC cells, by triggering apoptosis and causing alterations in autophagy. These findings highlight the need for additional studies to investigate the role of COE in the treatment of squamous cell carcinoma.
2024-01-23T09:03:57Z
2024-01-23T09:03:57Z
2023
2023-07-25
Thesis
http://hdl.handle.net/10725/15289
https://doi.org/10.26756/th.2023.646
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University
oai:laur.lau.edu.lb:10725/152942024-01-25T12:04:02Zcom_10725_2058col_10725_2074
Efficacy And Safety of Cannabidiol on Juvenile Diabetes Outcomes in Male Rats
Awkar, Nai
Diabetes in children--Treatment
Cannabis--Therapeutic use
Lebanese American University--Dissertations
Dissertations, Academic
Background: Cannabidiol (CBD) is a major non-psychotomimetic cannabinoid found in the Cannabis sativa plant with several pharmacological effects. Juvenile Diabetes is a major chronic illness that affects the life of patients. CBD presents desirable effects on hyperglycemia by protecting against oxidative stress and inflammation, having neuroprotective properties, and acting on receptors linked to glycemia. Thus, CBD has the potential to decrease HbA1C in diabetic patients (Diabetes Mellitus type 1) and improve their lives. Objective: The current research aims to explore the pharmacological effect of CBD on Juvenile Diabetes in rat models, as well as the safety profile of CBD including toxicology studies on the liver and the pancreas. Methods: The research was done by conducting experiments on young adult male Wistar rats. The rats were given streptozotocin (STZ) for Juvenile Diabetes induction. The rats were randomly assigned to four experiments for a total duration of 30 days. Each experiment contained a vehicle control group alongside several groups of different dosage regimens of CBD. Each Experiment consisted of a specific and required number of animals (according to the standardized toxicity tests for rodents). Results: The animal data and findings from this study offer the opportunity for a safe and effective oral drug for the treatment of Juvenile Diabetes to be considered for further research and clinical trials. Conclusion: The animal data from this study confirmed the safety of CBD when administered in different dosing regimens per body weight with NOAEL (the no-observed-adverse-effect level) = 150mg/kg. In addition, the results gave promising insights for considering CBD as an oral treatment option for juvenile diabetes as dose-dependent. The CBD dose of 50mg/kg when administered for 14 days was able to control blood glycemia values, body weights and produce insulin concentration levels that are close to normal values.
2024-01-25T12:04:02Z
2024-01-25T12:04:02Z
2023
2023-07-27
Thesis
http://hdl.handle.net/10725/15294
https://doi.org/10.26756/th.2023.642
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
en
Lebanese American University