2024-03-28T16:45:03Zhttps://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.
1 bound copy: xv, 39 leaves; ill. (some col.); 30 cm. available at RNL.
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.
1 bound copy: 76 p.; ill. available at RNL.
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.
1 bound copy: xii, 83 l. available at RNL.
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.
1 bound copy: 70 leaves available at RNL.
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.
1 bound copy: 64 p. available at RNL.
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)
performance in preventing myocardial infarction in young lebanese adults
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.
1 bound copy: vi, 30 leaves; ill. (some col.); 31 cm. available at RNL.
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.
1 bound copy: 121 p.; col. ill. available at RNL.
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).
1 bound copy: iv, 60 leaves; 30 cm. available at RNL.
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)
A comparative study
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.
1 bound copy: xvii, 29, [5] l. available at RNL.
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.
1 bound copy: xi, 64 leaves; ill. (some col.), map; 30 cm.; available at RNL.
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
1 bound copy: 48 p. available at RNL.
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.
1 bound copy: 27 p. available at RNL.
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.
1 bound copy: xi, 81 p. available at RNL.
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.
1 bound copy: xi, 45 leaves; ill. (some col.); 30 cm. available at RNL.
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.
1 bound copy: vii, 31 leaves; 30 cm. available at RNL.
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.
1 bound copy: xi, 54 p. Available at RNL.
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.
1 bound copy: 76 p. Available at RNL.
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).
1 bound copy: xiii, 257 leaves; ill.; 30 cm. available at RNL.
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.
1 bound copy: vii, 24 p.; 30 cm. available at RNL.
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:10725/21962016-12-02T09:18:23Zcom_10725_2058col_10725_2073
Evaluating the degree of difficulty of laparoscopic colorectal surgery
Dimassi, Hani
Jamali, Faek R.
Soweid, Asaad M.
Bailey, Charles
Leroy, Joel
Marescaux, Jacques
The introduction of laparoscopy has brought about great progress in current surgical practices. The benefits to patients, families, employers, and hospitals have been significant. The indications for laparoscopic surgery have gradually expanded over time as surgeons have gained more experience, with many laparoscopic procedures becoming standard practice.1- 4 The use of laparoscopic techniques in the field of colorectal surgery followed soon after the early success of laparoscopic cholecystectomy, with the first case reports published in 1991.5,6 Laparoscopy for colorectal surgery, however, has not been as readily embraced into surgical practice as other procedures, partly because of the requirement for advanced laparoscopic surgical skills and partly because of initial concerns about potential risks of tumor dissemination in malignant neoplasms. These concerns have now been addressed in randomized controlled trials that have shown that the laparoscopic approach is associated with the same significant short-term benefits without a compromise in oncological long-term outcomes.7- 10 It is therefore anticipated that there will be an increased demand for laparoscopic colorectal procedures in the future, with many surgeons entering this field.
The purpose of this study is to quantify the degree of difficulty involved in the performance of various laparoscopic colorectal procedures. It aims to elucidate the specific difficulties that are likely to be encountered by breaking down each surgical procedure into its key elements. This will provide a guide for surgeons who are learning these operations so they can choose appropriately which procedures to perform first and anticipate and prepare for the difficulties they are likely to encounter. It is hoped that proper case selection based on this data will result in a lower conversion rate, thereby benefiting patients and reducing operative times and costs.
Published
N/A
2015-09-29T07:10:29Z
2015-09-29T07:10:29Z
2008
2015-09-29
Article
2168-6254
http://hdl.handle.net/10725/2196
http://dx.doi.org/10.1001/archsurg.143.8.762
Jamali, F. R., Soweid, A. M., Dimassi, H., Bailey, C., Leroy, J., & Marescaux, J. (2008). Evaluating the degree of difficulty of laparoscopic colorectal surgery. Archives of Surgery, 143(8), 762-767.
http://archsurg.jamanetwork.com/article.aspx?articleid=600774&resultclick=1
en
JAMA Surgery
oai:laur.lau.edu.lb:10725/22002016-12-01T14:41:55Zcom_10725_2058col_10725_2073
Disciplinary action against physicians: Who is likely to get disciplined?
Dimassi, Hani
Khaliq, Amir A.
Huang, Chiung-Yu
Narine, Lutchmie
Smego, Raymond A.
PURPOSE: We sought to determine the characteristics of disciplined physicians at-large and the risk
of disciplinary action over time and to report the type and frequency of complaints and the nature of
disciplinary actions against allopathic physicians in Oklahoma.
METHODS: Descriptive statistics, Kaplan-Meier analysis, and Cox proportional hazards modeling of publicly
available data on physicians licensed by the Oklahoma Board of Medical Licensure and Supervision.
RESULTS: Among 14 314 currently or previously licensed physicians, 396 (2.8%) had been disciplined.
Using univariate proportional hazards analysis, men (P 0.04), non-whites (P 0.001), non-board-certified
physicians (P 0.001), and those in family medicine (P 0.001), psychiatry (P 0.001), general practice
(P 0.001), obstetrics-gynecology (P 0.03) and emergency medicine (P 0.001) were found to be at
greater risk of being disciplined than other medical specialty groups. Foreign medical graduates had a higher
risk of disciplinary action compared to US medical graduates (P 0.001), although this finding was not
confirmed by multivariate analysis. Kaplan-Meier analysis revealed that the proportion of physicians
disciplined increased with each successive 10-year interval since first licensure. Complaints against physicians
originated most often from the general public (66%), other physicians (5%), and staff (4%), and the
complaints most frequently involved issues related to quality of care (25%), medication/prescription
violations (19%), incompetence (18%), and negligence (17%).
CONCLUSION: To improve physician behavior and reduce the need for disciplinary action, medical
schools and residency training programs must continue to emphasize both patient care and medical
professionalism as critical core competencies
Published
N/A
2015-09-29T09:10:10Z
2015-09-29T09:10:10Z
2005
2015-09-29
Article
0002-9343
http://hdl.handle.net/10725/2200
http://dx.doi.org/10.1016/j.amjmed.2005.01.051
Khaliq, A. A., Dimassi, H., Huang, C. Y., Narine, L., & Smego, R. A. (2005). Disciplinary action against physicians: who is likely to get disciplined?. The American journal of medicine, 118(7), 773-777.
http://www.sciencedirect.com/science/article/pii/S0002934305001506
en
The American journal of medicine
oai:laur.lau.edu.lb:10725/22012019-03-04T13:10:20Zcom_10725_2058col_10725_2073
The impact of hospital accreditation on quality of care
Dimassi, Hani
El-Jardali, Fadi
Jamal, Diana
Ammar, Walid
Tchaghchaghian, Victoria
Background In developing countries, accreditation is increasingly being used as a tool for government regulation to guarantee quality of care. Although Lebanon is the first country in the East Mediterranean Region to develop and implement accreditation standards, little is known yet on its impact on quality of care.
Objective To assess the perceived impact of accreditation on quality of care through the lens of health care professionals, specifically nurses. This paper also investigates the perceived contributing factors that can explain change in quality of care.
Methods A cross-sectional survey design where all hospitals that successfully passed both national accreditation surveys (I and II) were included. A total of 1048 registered nurses from 59 hospitals were sampled. The survey tool, assessing quality of care and contributing factors, includes nine scales and subscales rated on five-point Likert scale.
Results The high score for the variable ‘Quality Results’ indicates that nurses perceived an improvement in quality during and after the accreditation process. Predictors of better Quality Results were Leadership, Commitment and Support, Use of Data, Quality Management, Staff Involvement and hospital size. The variable Quality Management, as measured by the scale Quality Management, had the greatest impact in medium-sized hospitals while the subscale measuring Staff Involvement had the greatest impact in small-sized hospitals.
Conclusion According to Lebanese nurses, hospital accreditation is a good tool for improving quality of care. In order to ensure that accreditation brings effective quality improvement practices, there is a need to assess quality based on patient outcome indicators.
Published
N/A
2015-09-29T09:28:28Z
2015-09-29T09:28:28Z
2008
2015-09-29
1464-3677
http://hdl.handle.net/10725/2201
http://dx.doi.org/10.1093/intqhc/mzn023
El-Jardali, F., Jamal, D., Dimassi, H., Ammar, W., & Tchaghchaghian, V. (2008). The impact of hospital accreditation on quality of care: perception of Lebanese nurses. International Journal for Quality in Health Care, 20(5), 363-371.
http://intqhc.oxfordjournals.org/content/20/5/363.short
en
International Journal for Quality in Health Care
oai:laur.lau.edu.lb:10725/22032019-03-04T12:52:36Zcom_10725_2058col_10725_2073
Exposure to war-related traumatic events, prevalence of PTSD, and general psychiatric morbidity in a civilian population from Southern Lebanon
Dimassi, Hani
Farhood, Laila
Lehtinen, Tuja
The South of Lebanon has experienced prolonged armed conflict. The current study aims to investigate the degree of exposure to traumatic events and prevalence of posttraumatic stress disorder (PTSD) and nonspecific general psychiatric morbidity in a civilian population from the South of Lebanon. The design was cross-sectional with random sampling. War-related traumatic events and symptoms of PTSD were assessed by the Harvard Trauma Questionnaire and general psychiatric morbidity by the General Health Questionnaire (GHQ-28). Almost all participants, 97.7%, had experienced, witnessed, or heard of a war-related traumatic event. Current PTSD prevalence was 29.3%. PTSD symptoms correlated highly with GHQ-28 symptoms, r = .73 (p < .0001). The present study indicates a need for psychological interventions in the population and studies to assess such interventions.
Published
N/A
2015-09-29T11:52:12Z
2015-09-29T11:52:12Z
2006
2015-09-29
Article
1043-6596
http://hdl.handle.net/10725/2203
http://dx.doi.org/10.1177/1043659606291549
Farhood, L., Dimassi, H., & Lehtinen, T. (2006). Exposure to war-related traumatic events, prevalence of PTSD, and general psychiatric morbidity in a civilian population from Southern Lebanon. Journal of Transcultural Nursing, 17(4), 333-340.
http://tcn.sagepub.com/content/17/4/333.short
en
Journal of Transcultural Nursing
oai:laur.lau.edu.lb:10725/22042019-03-04T13:04:52Zcom_10725_2058col_10725_2073
Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer
Dimassi, Hani
Hatoum, Hassan A.
Jamali, Faek R.
El-Saghir, Nagi
Mussallam, Khaled M.
Background.
The status of the axillary lymph nodes in nonmetastatic lymph node-positive breast cancer (BC) patients remains the single most important determinant of overall survival (OS). Although the absolute number of nodes involved with cancer is important for prognosis, the role of the total number of excised nodes has received less emphasis. Thus, several studies have focused on the utility of the axillary lymph node ratio (ALNR) as an independent prognostic indicator of OS. However, most studies suffered from shortcomings, such as including patients who received neoadjuvant therapy or failing to consider the use of adjuvant therapy and tumor receptor status in their analysis.
Methods.
We conducted a single-center retrospective review of 669 patients with nonmetastatic lymph nodepositive BC. Data collected included patient demographics; breast cancer risk factors; tumor size, histopathological, receptor, and lymph node status; and treatment modalities used. Patients were subdivided into four groups according to ALNR value (<.25, .25–.49, .50–.74, .75–1.00). Study parameters were compared at the univariate and multivariate levels for their effect on OS.
Results.
On univariate analysis, both the absolute number of positive lymph nodes and the ALNR were significant predictors of OS. On multivariate analysis, only the ALNR remained an independent predictor of OS, with a 2.5-fold increased risk of dying at an ALNR of ≥.25.
Conclusions.
Our study demonstrates that ALNR is a stronger factor in predicting OS than the absolute number of positive axillary lymph nodes.
Published
N/A
2015-09-29T12:16:29Z
2015-09-29T12:16:29Z
2009
2015-09-29
Article
0975-7651
http://hdl.handle.net/10725/2204
http://dx.doi.org/10.1007/s13193-011-0062-x
Hatoum, H. A., Jamali, F. R., El-Saghir, N. S., Musallam, K. M., Seoud, M., Dimassi, H., ... & Shamseddine, A. I. (2010). Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer. Indian journal of surgical oncology, 1(4), 305-312.
Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer
en
Indian Journal of Surgical Oncology
oai:laur.lau.edu.lb:10725/22052016-08-22T08:11:25Zcom_10725_2058col_10725_2073
A national cross-sectional study on nurses' intent to leave and job satisfaction in Lebanon
Implications for policy and practice
El-Jardali, F.
Dimassi, Hani
Dumit, N.
Jamal, D.
Mouro, G.
Background: Lebanon is perceived to be suffering from excessive nurse migration, low job satisfaction,
poor retention and high turnover. Little is known about the magnitude of nurse migration and predictors
of intent to leave. The objective of this study is to determine the extent of nurses' intent to leave and
examine the impact of job satisfaction on intent to leave. Intent to leave was explored to differentiate
between nurses who intend to leave their current hospital and those intending to leave the country.
Methods: A cross-sectional design was used to survey nurses currently practicing in Lebanese hospitals.
A total of 1,793 nurses employed in 69 hospitals were surveyed. Questions included those relating to
demographic characteristics, intent to leave, and the McCloskey Mueller Satisfaction Scale. Univariate
descriptive statistics were conducted on sample's demographic characteristics including gender, age,
marital status and educational level. Bivariate associations between intent to leave and demographic
characteristics were tested using Pearson Chi-square. Differences in satisfaction scores between nurses
with and without intent to leave were tested using t-test and ANOVA f-test. A multinomial logistic
regression model was created to predict intent to leave the hospital and intent to leave the country.
Results: An alarming 67.5% reported intent to leave within the next 1 to 3 years, many of whom disclosed
intent to leave the country (36.7%). Within nurses who reported an intent to leave the hospital but stay
in Lebanon, 22.1% plan to move to a different health organization in Lebanon, 29.4% plan to leave the
profession and 48.5% had other plans. Nurses reported being least satisfied with extrinsic rewards. A
common predictor of intent to leave the hospital and the country was dissatisfaction with extrinsic
rewards. Other predictors of intent to leave (country or hospital) included age, gender, marital status,
degree type, and dissatisfaction with scheduling, interaction opportunities, and control and responsibility.
Conclusion: Study findings demonstrate linkages between job satisfaction, intent to leave, and migration
in a country suffering from a nursing shortage. Findings can be used by health care managers and policy
makers in managing job satisfaction, intent to leave and nurse migration.
Published
N/A
2015-09-29T12:28:27Z
2015-09-29T12:28:27Z
2009
2015-09-29
Article
1472-6955
http://hdl.handle.net/10725/2205
http://dx.doi.org/10.1186/1472-6955-8-3
El-Jardali, F., Dimassi, H., Dumit, N., Jamal, D., & Mouro, G. (2009). A national cross-sectional study on nurses' intent to leave and job satisfaction in Lebanon: implications for policy and practice. BMC nursing, 8(1), 3.
https://bmcnurs.biomedcentral.com/articles/10.1186/1472-6955-8-3
en
BMC Nusing
oai:laur.lau.edu.lb:10725/22062019-03-21T09:19:13Zcom_10725_2058col_10725_2073
Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon
Dimassi, Hani
Karam, Elie G.
Fayyad, John
Karam, Aimee Nasser
Melhem, Nadine
Mneimneh, Zeina
Tabet, Caroline Cordahi
The purpose of this study was to examine the effectiveness and specificity of a classroom-based psychosocial intervention after war. All students
(n=2500) of six villages in Southern Lebanon designated as most heavily exposed to war received a classroom-based intervention delivered
by teachers, consisting of cognitive-behavioural and stress inoculation training strategies. A random sample of treated students
(n=101) and a matched control group (n=93) were assessed one month post-war and one year later. Mental disorders and psychosocial stressors
were assessed using the Diagnostic Interview for Children and Adolescents - Revised with children and parents. War exposure was
measured using the War Events Questionnaire. The prevalence of major depressive disorder (MDD), separation anxiety disorder (SAD) and
post-traumatic stress disorder (PTSD) was examined pre-war, one month post-war (pre-intervention), and one year post-war. Specificity of
treatment was determined by rating teachers’ therapy diaries. The rates of disorders peaked one month post-war and decreased over one
year. There was no significant effect of the intervention on the rates of MDD, SAD or PTSD. Post-war MDD, SAD and PTSD were associated
with pre-war SAD and PTSD, family violence parameters, financial problems and witnessing war events. These findings have significant
policy and public health implications, given current practices of delivering universal interventions immediately post-war.
Published
N/A
2015-09-29T12:45:08Z
2015-09-29T12:45:08Z
2008
2015-09-29
Article
1723-8617
http://hdl.handle.net/10725/2206
http://dx.doi.org/10.1002/j.2051-5545.2008.tb00170.x
Karam, E. G., Fayyad, J., Karam, A. N., Tabet, C. C., Melhem, N., Mneimneh, Z., & Dimassi, H. (2008). Effectiveness and specificity of a classroom‐based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry, 7(2), 103-109.
http://onlinelibrary.wiley.com/doi/10.1002/j.2051-5545.2008.tb00170.x/full
en
World Psychiatry
oai:laur.lau.edu.lb:10725/22082016-12-02T11:51:53Zcom_10725_2058col_10725_2073
Predictors and outcomes of patient safety culture in hospitals
Dimassi, Hani
El-Jardali, Fadi
Jamal, Diana
Jaafar, Maha
Hemadeh, Nour
Background
Developing a patient safety culture was one of the recommendations made by the Institute of Medicine to assist hospitals in improving patient safety. In recent years, a multitude of evidence, mostly originating from developed countries, has been published on patient safety culture. One of the first efforts to assess the culture of safety in the Eastern Mediterranean Region was by El-Jardali et al. (2010) in Lebanon. The study entitled "The Current State of Patient Safety Culture: a study at baseline" assessed the culture of safety in Lebanese hospitals. Based on study findings, the objective of this paper is to explore the association between patient safety culture predictors and outcomes, taking into consideration respondent and hospital characteristics. In addition, it will examine the correlation between patient safety culture composites.
Methods
Sixty-eight hospitals and 6,807 respondents participated in the study. The study which adopted a cross sectional research design utilized an Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC). The HSOPSC measures 12 patient safety composites. Two of the composites, in addition to a patient safety grade and the number of events reported, represented the four outcome variables. Bivariate and mixed model regression analyses were used to examine the association between the patient safety culture predictors and outcomes.
Results
Significant correlations were observed among all patient safety culture composites but with differences in the strength of the correlation. Generalized Estimating Equations for the patient safety composite scores and respondent and hospital characteristics against the patient safety grade and the number of events reported revealed significant correlations. Significant correlations were also observed by linear mixed models of the same variables against the frequency of events reported and the overall perception of safety.
Conclusion
Event reporting, communication, patient safety leadership and management, staffing, and accreditation were identified as major patient safety culture predictors. Investing in practices that tackle these issues and prioritizing patient safety is essential in Lebanese hospitals in order to improve patient safety. In addition, further research is needed to understand the association between patient safety culture and clinical outcomes.
Published
N/A
2015-09-30T07:40:00Z
2015-09-30T07:40:00Z
2011
2015-09-30
Article
1472-6963
http://hdl.handle.net/10725/2208
http://dx.doi.org/10.1186/1472-6963-11-45
El-Jardali, F., Dimassi, H., Jamal, D., Jaafar, M., & Hemadeh, N. (2011). Predictors and outcomes of patient safety culture in hospitals. BMC health services research, 11(1), 45.
http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-11-45
en
BMC health services research
oai:laur.lau.edu.lb:10725/22092019-03-04T12:50:14Zcom_10725_2058col_10725_2073
The current state of patient safety culture in Lebanese hospitals
A study at baseline
Dimassi, Hani
El-Jardali, Fadel
Jaafar, Maha
Jamal, Diana
Hamdan, Rana
Objective The objective of this study is to conduct a baseline assessment of patient safety culture in Lebanese hospitals.
Design The study adopted a cross-sectional research design and utilized the hospital survey on patient safety culture (HSOPSC).
Setting Sixty-eight Lebanese hospitals participated in the study (54% of all hospitals).
Participants A total of 6807 hospital employees participated in the study including hospital-employed physicians, nurses, clinical and non-clinical staff, and others.
Main Outcome Measures The HSOPSC measures 12 composites of patient safety culture. Two of the composites (frequency of events reported and overall perception of safety), in addition to questions on patient safety grade and number of events reported, are the four outcome variables.
Results Survey respondents were primarily employed in medical and surgical units. The dimensions with the highest positive ratings were teamwork within units, hospital management support for patient safety, and organizational learning and continuous improvement, while those with lowest ratings included staffing and non-punitive response to error. Approximately 60% of respondents reported not completing any event reports in the past 12 months and over 70% gave their hospitals an ‘excellent/very good’ patient safety grade. Bivariate and multivariate analysis revealed significant differences across hospitals of different size and accreditation status.
Conclusions Study findings provide evidence that can be used by policy makers, managers and leaders who are able to create the culture and commitment needed to identify and solve underlying systemic causes related to patient safety.
Published
N/A
2015-09-30T07:56:54Z
2015-09-30T07:56:54Z
2010
2015-09-30
Article
0952-6862
http://hdl.handle.net/10725/2209
http://dx.doi.org/10.1093/intqhc/mzq047
El-Jardali, F., Jaafar, M., Dimassi, H., Jamal, D., & Hamdan, R. (2010). The current state of patient safety culture in Lebanese hospitals: a study at baseline. International Journal for Quality in Health Care, 22(5), 386-395.
http://intqhc.oxfordjournals.org/content/22/5/386?rss%253D1=
en
International Journal for Quality in Health Care
oai:laur.lau.edu.lb:10725/22112020-06-22T11:04:11Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
Characterisation of Pga1, a putative Candida albicans cell wall protein necessary for proper adhesion and biofilm formation
Malouf, Katia
Dimassi, Hani I.
Khalaf, Roy A.
Hashash, Rami
Younes, Samer
Bahnan, Wael
El-Koussa, Joseph
The fungal pathogen Candida albicans is a leading causative agent of death in immunocompromised individuals. Many factors have been implicated in virulence including filamentation-inducing transcription factors, adhesins, lipases and proteases. Many of these factors are glycosylphosphatidylinositol-anchored cell surface antigenic determinant proteins. Pga1 is one such protein shown to be upregulated during cell wall regeneration. The purpose of this study was to characterise the role Pga1 plays by creating a homozygous pga1 null strain and comparing the phenotype with the parental strain. It was observed that the mutant strain showed less oxidative stress tolerance and an increased susceptibility to calcofluor white, a cell surface disrupting agent that inhibits chitin fibre assembly which translated as a 40% decrease in cell wall chitin content. Furthermore, the mutant exhibited a 50% reduction in adhesion and a 33% reduction in biofilm formation compared with the parental strain, which was reflected as a slight reduction in virulence. Our data suggest that Pga1 plays an important role in cell wall rigidity and stability. It was also observed that the pga1 null was over filamentous on both liquid and solid media and exhibited increased resistance to SDS suggesting upregulation of filamentation-inducing genes and cell surface components to partially compensate for the deletion.
Published
N/A
2015-09-30T08:23:14Z
2015-09-30T08:23:14Z
2015-09-30
Article
1439-0507
http://hdl.handle.net/10725/2211
http://dx.doi.org/10.1111/j.1439-0507.2010.01883.x
Hashash, R., Younes, S., Bahnan, W., El Koussa, J., Maalouf, K., Dimassi, H. I., & Khalaf, R. A. (2011). Characterisation of Pga1, a putative Candida albicans cell wall protein necessary for proper adhesion and biofilm formation. Mycoses, 54(6), 491-500.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0507.2010.01883.x/full
en
Mycoses
oai:laur.lau.edu.lb:10725/22172020-06-22T11:00:44Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
The Candida albicans Hwp2 is necessary for proper adhesion, biofilm formation and oxidative stress tolerance
Dimassi, Hani I.
Khalaf, Roy A.
Younes, Samer
Bahnan, Wael
Candida albicans is an important fungal pathogen of humans that is responsible for the majority of mucosal and systemic candidiasis. The host–pathogen interaction in C. albicans has been the subject of intense investigation as it is the primary step that leads to establishment of infection. Hwp2 is a cell wall GPI-anchored cell wall protein that was previously shown to be necessary for hyphal and invasive growth on solid media. The purpose of the current study is to further characterize the protein as far as its role in oxidative stress, sensitivity to cell wall disrupting agents, adhesion to human epithelial and endothelial cells, biofilm formation and chitin content. It appears that Hwp2 is necessary for proper oxidative stress tolerance, adhesion and biofilm formation as an hwp2 null is more susceptible to increasing doses of hydrogen peroxide, unable to adhere efficiently to epithelial and endothelial cell lines and unable to form wild type biofilm levels.
Published
N/A
2015-09-30T09:00:24Z
2015-09-30T09:00:24Z
2011
2015-09-30
Article
0944-5013
http://hdl.handle.net/10725/2217
http://dx.doi.org/10.1016/j.micres.2010.08.004
Younes, S., Bahnan, W., Dimassi, H. I., & Khalaf, R. A. (2011). The Candida albicans Hwp2 is necessary for proper adhesion, biofilm formation and oxidative stress tolerance. Microbiological research, 166(5), 430-436.
http://www.sciencedirect.com/science/article/pii/S0944501310000789
en
Microbiological research
oai:laur.lau.edu.lb:10725/22212019-03-04T13:01:47Zcom_10725_2058col_10725_2073
Palliative care in Lebanon
Knowledge, attitudes and practices of nurses
Dimassi, Hani
Huijer, Huda Abu-Saad
Abboud, Sarah
Aim: To determine the knowledge, attitudes, and practices of palliative care nurses in Lebanon. Method: Cross-sectional descriptive survey using self-administered questionnaire; 1873 nurses from 15 hospitals were included. Results: Non-clinical nurses had better knowledge on the outcomes of palliative care than all other specialties. Oncology nurses had more favourable attitudes than other specialties with regard to informing patients about their diagnosis, patients having the right to 'do-not-resuscitate', involving patients in treatment choices, and respecting their wishes for alternative therapy. Surgical, acute critical care, and obstetric/gynaecology nurses had significantly more negative attitudes towards patients' and families' questions and concerns than other specialties. Conclusion: Formal education in palliative care and development of palliative care services are needed in Lebanon to provide quality care to terminally ill patients.
Published
N/A
2015-09-30T11:13:29Z
2015-09-30T11:13:29Z
2009
2015-09-30
Article
1357-6321
http://hdl.handle.net/10725/2221
Huijer, H. A. S., Abboud, S., & Dimassi, H. (2009). Palliative care in Lebanon: Knowledge, attitudes and practices of nurses. International journal of palliative nursing, 15(7).
http://web.a.ebscohost.com/ehost/detail/detail?sid=12bf1db3-4e03-42ba-b517-3b191ba0d2a3%40sessionmgr4006&vid=0&hid=4109&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&AN=43757464
en
International Journal of Palliative Nursing
oai:laur.lau.edu.lb:10725/22222016-08-22T09:29:25Zcom_10725_2058col_10725_2073
Prevalence and treatment of mental disorders in Lebanon: a national epidemiological survey
Nasser, Soumana
Karam, Elie G
Mneimneh, Zeina N.
Karam, Aimee N.
Fayyad, John A.
Chatterji, Somnath
Kessler, Ronald C.
Background
Mental disorders are believed to account for a large portion of disease burden worldwide. However, no national studies have been undertaken to assess this assumption in the Arab world.
Methods
As part of the WHO World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of 2857 adults (aged ⩾18 years) was done in Lebanon between September, 2002, and September, 2003, through a study called LEBANON (Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation). 12-month prevalence and severity of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) disorders, and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, version 3.0). Information was also obtained for sociodemographics and exposure to traumatic events in the Lebanon wars.
Findings
308 (17·0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 108 (27·0%) of whom were classified serious and an additional 112 (36·0%) moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odds ratios (OR) of mood, anxiety, and impulse-control disorders were associated with two (OR 2·0–3·6) or more (2·2–9·1) war-related traumatic events, resulting in substantially higher proportions of moderate and severe 12-month mental disorders in respondents exposed to multiple war-related traumata (16·8–20·4%) compared with other respondents (3·3–3·5%). Only 47 (10·9%) respondents with 12-month disorders obtained treatment. 85% of people were treated in the general medical sector and the mental-health-care system, and the rest by religious or spiritual advisers, counsellors, herbalists, or fortune-tellers.
Interpretation
Mental disorders are common in Lebanon, with a prevalence equivalent to that in Western Europe. However, the number of individuals with mental disorders who are not receiving treatment is considerably higher in Lebanon than in Western countries.
Published
N/A
2015-09-30T12:21:23Z
2015-09-30T12:21:23Z
2006
2015-09-30
Article
0140-6736
http://hdl.handle.net/10725/2222
http://dx.doi.org/10.1016/S0140-6736(06)68427-4
Karam, E. G., Mneimneh, Z. N., Karam, A. N., Fayyad, J. A., Nasser, S. C., Chatterji, S., & Kessler, R. C. (2006). Prevalence and treatment of mental disorders in Lebanon: a national epidemiological survey. The Lancet, 367(9515), 1000-1006.
http://www.sciencedirect.com/science/article/pii/S0140673606684274
en
The Lancet
oai:laur.lau.edu.lb:10725/22232019-03-04T12:52:15Zcom_10725_2058col_10725_2073
An evaluation of practice pattern for venous thromboembolism prevention in Lebanese hospitals
Dimassi, Hani
Zeitoun, Abeer A.
El-Kary, Dania Y.
Akel, Marwan G.
Background Venous thromboembolism (VTE) is a major cause of death among hospitalized patients. Many VTE prophylaxis guidelines have been developed, including the American College of Chest Physicians (ACCP). VTE prophylaxis is required in specific patients; however, its practice is not always optimal, and often depends on the hospitals’ protocols. In Lebanon, information about the appropriateness of VTE prophylaxis in health care centers is lacking. Objective The primary objective of this study was to evaluate the pattern of VTE prophylaxis application, including agents, doses, duration of treatment, and route of administration, in Lebanese health care centers. Methods A Lebanese multi-center, prospective, chart review study was conducted over 4 months. Data on demographics, VTE prophylaxis medication, dose, route, duration, and associated risk factors were collected by pharmacy students. The appropriateness of VTE prophylaxis was determined as per ACCP guidelines. Patients receiving VTE treatment were excluded from the study. Institutional review board (IRB) approval was obtained from each hospital center. Results A total of 840 patients were included. Both gender groups were equally represented in the sample and the mean age was 59 ± 19.53 years. The majority (639/840, 76.1%) of the sample were at high risk for deep venous thrombosis (DVT), and inappropriate VTE prophylaxis was reported in 35% of the low-risk group, in 70% of the moderate-risk group, and in 39% of the high-risk group (P < 0.0001). Comparing proper VTE prophylaxis practice between intensive care unit (ICU) and non-ICU patients, there was no statistical difference observed in teaching hospitals (67.2% vs. 65.5%, P = 0.312). However, in non-teaching hospitals, appropriate VTE prophylaxis practice was more prevalent in ICU than non-ICU patients (65.9% vs. 51.2%, P = 0.004). The average duration of VTE prophylaxis was less than 10 days. Missing data was a major limitation for this study, where, for instance, the duration of prophylaxis could not be accurately abstracted in half of the sample. Another limitation was the absence of laboratory results needed for clinical assessment of the regimen used. Conclusion This study reflected the importance of assessing VTE prophylaxis in Lebanese hospitals, thus, the need for implementing established guidelines to improve the overall patient safety.
Published
N/A
2015-09-30T13:01:25Z
2015-09-30T13:01:25Z
2015-09-30
Article
0929-5305
http://hdl.handle.net/10725/2223
http://dx.doi.org/10.1007/s11239-008-0298-7
Zeitoun, A. A., Dimassi, H. I., El Kary, D. Y., & Akel, M. G. (2009). An evaluation of practice pattern for venous thromboembolism prevention in Lebanese hospitals. Journal of thrombosis and thrombolysis, 28(2), 192-199.
http://link.springer.com/article/10.1007/s11239-008-0298-7
en
Journal of thrombosis and thrombolysis
oai:laur.lau.edu.lb:10725/22242019-03-04T13:00:30Zcom_10725_2058col_10725_2073
Nurses' Attitudes Toward the Use of the Bar-coding Medication Administration System
Dimassi, Hani
Marini, Sana Daya
Hasman, Arie
Huijer, Huda Abu-Saad
This study determines nurses' attitudes toward bar-coding medication administration system use. Some of the factors underlying the successful use of bar-coding medication administration systems that are viewed as a connotative indicator of users' attitudes were used to gather data that describe the attitudinal basis for system adoption and use decisions in terms of subjective satisfaction. Only 67 nurses in the United States had the chance to respond to the e-questionnaire posted on the CARING list server for the months of June and July 2007. Participants rated their satisfaction with bar-coding medication administration system use based on system functionality, usability, and its positive/negative impact on the nursing practice. Results showed, to some extent, positive attitude, but the image profile draws attention to nurses' concerns for improving certain system characteristics. The high bar-coding medication administration system skills revealed a more negative perception of the system by the nursing staff. The reasons underlying dissatisfaction with bar-coding medication administration use by skillful users are an important source of knowledge that can be helpful for system development as well as system deployment. As a result, strengthening bar-coding medication administration system usability by magnifying its ability to eliminate medication errors and the contributing factors, maximizing system functionality by ascertaining its power as an extra eye in the medication administration process, and impacting the clinical nursing practice positively by being helpful to nurses, speeding up the medication administration process, and being user-friendly can offer a congenial settings for establishing positive attitude toward system use, which in turn leads to successful bar-coding medication administration system use.
Published
N/A
2015-09-30T13:25:30Z
2015-09-30T13:25:30Z
2010
2015-09-30
Article
1538-2931
http://hdl.handle.net/10725/2224
http://dx.doi.org/10.1097/NCN.0b013e3181cd80f6
Marini, S. D., Hasman, A., Huijer, H. A. S., & Dimassi, H. (2010). Nurses' attitudes toward the use of the bar-coding medication administration system. Computers Informatics Nursing, 28(2), 112-123.
http://journals.lww.com/cinjournal/Abstract/2010/03000/Nurses__Attitudes_Toward_the_Use_of_the_Bar_coding.10.aspx
en
Computers Informatics Nursing
oai:laur.lau.edu.lb:10725/22252019-03-04T13:00:52Zcom_10725_2058col_10725_2073
Nurses’ work environment and intent to leave in Lebanese hospitals
Implications for policy and practice
Dimassi, Hani
El-Jardali, Fadi
Alameddine, Mohamad
Dumit, Nuhad
Jamal, Diana
Maalouf, Salwa
Background
The dual burden of nursing shortages and poor work environments threatens quality of patient care and places additional pressures on resource-stretched health care systems, particularly in the Eastern Mediterranean Region (EMR). There is a paucity of research in the EMR examining the quality of nurses’ work environment and its association to nurses’ intent to leave their jobs/countries.
Objectives
Systematically examine the characteristics of nurses’ work environment and their relation to nurses’ intent to leave their jobs within the context of Lebanon. A secondary objective is to assess the utility and validity of the NWI-R within the context of the EMR.
Methods
A cross-sectional survey design was utilized to survey a total of 1793 registered nurses in 69 Lebanese hospitals. The survey instrument included questions on nurses’ background, hospital characteristics, intent to leave, and the Revised Nurse Working Index (NWI-R). Data analysis included descriptive statistics for demographic characteristics, t-test and ANOVA to assess differences in agreement scores, and a multinomial logistic regression model to predict intent to leave. Thematic analysis of open-ended questions was utilized to extract themes that fit under issues relating to nurses’ work environment in Lebanese hospitals.
Results
The NWI-R subscale with the lowest mean score related to control. Younger nurses had lower scores on organizational support and career development. Regression analysis revealed that for every 1 point score decrease on career development there was a 93% increase in likelihood of reporting intent to leave country. Likewise, for every 1 point score decrease on participation there was an observed 51% and 53% increase in likelihood of reporting intent to leave country and hospital, respectively. Findings show that hospital characteristics (size, accreditation status and presence of a recruitment and retention strategy) were significantly associated with NWI-R subscales.
Conclusions
Participation, control and career development were key work environment challenges contributing to the attrition on nurses from Lebanese hospitals. Although some of the issues identified are country specific, others would certainly be relevant to other countries in the EMR. Addressing these challenges would require a strong and coordinated action from governments, professional bodies, policy makers and health managers.
Published
N/A
2015-10-01T06:33:46Z
2015-10-01T06:33:46Z
2011
2015-10-01
Article
0020-7489
http://hdl.handle.net/10725/2225
http://dx.doi.org/10.1016/j.ijnurstu.2010.07.009
El-Jardali, F., Alameddine, M., Dumit, N., Dimassi, H., Jamal, D., & Maalouf, S. (2011). Nurses’ work environment and intent to leave in Lebanese hospitals: implications for policy and practice. International journal of nursing studies, 48(2), 204-214.
http://www.sciencedirect.com/science/article/pii/S0020748910002208
en
International Journal of Nursing Studies
oai:laur.lau.edu.lb:10725/22262019-03-04T12:49:58Zcom_10725_2058col_10725_2073
Clinical correlates of white-matter abnormalities on head magnetic resonance imaging
Dimassi, Hani
Lasbury, Nora
Garg, Bhuwan
Cowan, Linda D.
Edwards-Brown, Mary
Bodensteiner, John B.
We undertook this study to investigate the relationship between white-matter abnormalities (seen on brain magnetic resonance imaging [MRI]) and muscle tone and muscle stretch reflexes on clinical examination. We identified all patients less than 5 years of age who had undergone cranial MRI studies at Riley Hospital for Children between June 30, 1999, and July 1, 2000, whose scans were read as showing white-matter abnormalities. We measured two ratios and the thickness of the corpus callosum as indicators of the quantity of cerebral white matter. The ratios were R1, the ratio of the thickness of the white matter at the level just above the body of the lateral ventricle compared with the width of the hemisphere, and R2, the ratio of the thickness of the white matter to the width of the hemisphere at the level of the trigone of the lateral ventricle. The thickness of the corpus callosum was measured at the junction of the anterior two thirds and the posterior third. We also evaluated the signal intensity of the cerebral white matter by reviewing the fluid-attenuated inversion-recovery images and grading the signal as normal to severely abnormal depending on the degree and extent of high signal intensity seen (0 = normal to 4+). Thirty-eight children less than 5 years of age who underwent MRI scans between June and August 2000 and who were found to have normal tone prospectively and normal MRI scan on review served as a control group. We identified 215 patients who had white-matter abnormalities; of these, only 142 (66%) had documented tone assessments in their medical record. Our study group was divided into three groups: increased (n = 35), decreased (n = 53), and normal tone (n = 54). All three measurements of white matter in each of the three study groups were significantly below values for control children. The children with white-matter abnormalities and decreased tone had significantly less signal intensity abnormality than the other study groups. Children with white-matter abnormalities and increased tone had a greater frequency of increased reflexes and tended to have more signal abnormalities than the other groups. The group of children with white-matter abnormalities and normal tone had the least amount of cerebral white-matter deficiency of the three study groups. In patients with strikingly decreased quantities of cerebral white matter, those with normal signal-intensity white matter are likely to be hypotonic with normal reflexes and those with increased signal intensity in the white matter are likely to be spastic. (J Child Neurol 2001;16:668-672).
Published
N/A
2015-10-01T06:52:37Z
2015-10-01T06:52:37Z
2001
2015-10-01
Article
0883-0738
http://hdl.handle.net/10725/2226
http://dx.doi.org/10.1177/088307380101600908
Lasbury, N., Garg, B., Edwards-Brown, M., Cowan, L. D., Dimassi, H., & Bodensteiner, J. B. (2001). Clinical correlates of white-matter abnormalities on head magnetic resonance imaging. Journal of child neurology, 16(9), 668-672.
http://jcn.sagepub.com/content/16/9/668.short
en
Journal of Child Neurology
oai:laur.lau.edu.lb:10725/22272019-03-04T13:03:19Zcom_10725_2058col_10725_2073
Prevalence and predictors for post-traumatic stress disorder, depression and general health in a population from six villages in South Lebanon
Dimassi, Hani
Farhood, Laila F.
Objective
To determine the prevalence and predictors of psychiatric disorders in a general population from South Lebanon, an area that was under military occupation for more than 20 years.
Method
This study assessed post-traumatic stress disorder (PTSD) and depression thresholds along with general health (GHQ) among 625 citizens in six villages in South Lebanon using a cross-sectional design through random sampling.
Results
The prevalence ranged from 17.6 to 33.3% for PTSD and from 9.2 to 19.7% for depression. GHQ total score was found to be 6.7 significantly greater than the internationally established mean score of 5.0. Social support, financial resources, gender, and war exposure were significantly related to PTSD and depression thresholds.
Conclusion
The results strongly suggest that the general population in South Lebanon suffer from mental health disorders calling for appropriate psychiatric interventions and development planning.
Published
N/A
2015-10-01T08:12:54Z
2015-10-01T08:12:54Z
2012
2015-10-01
Article
0933-7954
http://hdl.handle.net/10725/2227
http://dx.doi.org/10.1007/s00127-011-0368-6
Farhood, L. F., & Dimassi, H. (2012). Prevalence and predictors for post-traumatic stress disorder, depression and general health in a population from six villages in South Lebanon. Social psychiatry and psychiatric epidemiology, 47(4), 639-649.
http://link.springer.com/article/10.1007/s00127-011-0368-6
en
Social psychiatry and psychiatric epidemiology
oai:laur.lau.edu.lb:10725/22282016-12-02T09:43:48Zcom_10725_2058col_10725_2073
Lifetime prevalence of mental disorders in Lebanon
First onset, treatment, and exposure to war
Dimassi, Hani
Karam, Elie G.
Mneimneh, Zeina N.
Fayyad, John A.
Karam, Aimee N.
Nasser, Soumana C.
Kessler, Ronald C.
Background
There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon.
Methods and Findings
The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults). Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder was 25.8%. Anxiety (16.7%) and mood (12.6%) were more common than impulse control (4.4%) and substance (2.2%) disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y) between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5–14.1), mood (OR 3.32, 95% CI 2.0–5.6), and impulse control disorders (OR 12.72, 95% CI 4.5–35.7).
Conclusions
About one-fourth of the sample (25.8%) met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders.
N/A
N/A
2015-10-01T09:29:19Z
2015-10-01T09:29:19Z
2015-10-01
Article
1016-8923
http://hdl.handle.net/10725/2228
http://dx.doi.org/10.1371/journal.pmed.0050061
Karam, E. G., Mneimneh, Z. N., Dimassi, H., Fayyad, J. A., Karam, A. N., Nasser, S. C., ... & Kessler, R. C. (2008). Lifetime prevalence of mental disorders in Lebanon: First onset, treatment, and exposure to war. PLoS Med, 5(4), e61.
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050061
The Arab Journal of Psychiatry
oai:laur.lau.edu.lb:10725/22322019-03-04T12:53:59Zcom_10725_2058col_10725_2073
Long-term phonatory instability in ataxic dysarthria
Dimassi, Hani
Boutsen, Frank
Duffy, Joseph R.
Christman, Sarah S.
Aims: Long-term phonatory instability can be quantified using cyclical and noncyclical measures. The objective of this study is to evaluate phonation in ataxic dysarthria and a control group of normal speakers to answer two main questions: (1) How common is elevated cyclical and noncyclical instability in ataxic dysarthria compared to that in a normal control group? (2) Is cyclical instability predictive of noncyclical instability? Methods: Vowel prolongations of ataxic-dysarthric and normal speakers were compared using the Motor Speech Profile module of the Computerized Speech Lab. Cyclical measures included tremor rate, amplitude and periodicity. Noncyclical measures included the coefficient of variation for loudness and frequency. Results: Noncyclical measures are elevated in a subset of speakers with ataxic dysarthria regardless of whether cyclical instability (vocal tremor) is present. Cyclical instability was detected in nearly half the patients. Interestingly, elevations in both types of measures also described phonation of a number of the participants in the control group. Conclusion: Combined use of cyclical and noncyclical measures can document aspects of phonation in ataxic dysarthria that have clinical implications.
Published
N/A
2015-10-01T12:23:01Z
2015-10-01T12:23:01Z
2011
2015-10-01
Article
1021-776
http://hdl.handle.net/10725/2232
http://dx.doi.org/10.1159/000319971
Boutsen, F., Duffy, J. R., Dimassi, H., & Christman, S. S. (2011). Long-term phonatory instability in ataxic dysarthria. Folia Phoniatrica et Logopaedica, 63(4), 216-220.
http://www.karger.com/Article/Abstract/319971
en
Folia Phoniatrica et Logopaedica,
oai:laur.lau.edu.lb:10725/22302016-12-01T14:34:21Zcom_10725_2058col_10725_2073
Clinical and cost impact of intravenous proton pump inhibitor use in non-ICU patients
Nasser, Soumana C.
Dimassi, Hani I.
Nassif, Jeanette G.
AIM: To assess the appropriateness of the indication and route of administration of proton-pump-inhibitors (PPIs) and their associated cost impact.
METHODS: Data collection was performed prospectively during a 6-mo period on 340 patients who received omeprazole intravenously during their hospital stay in non-intensive care floors. Updated guidelines were used to assess the appropriateness of the indication and route of administration.
RESULTS: Complete data collection was available for 286 patients which were used to assess intravenous (IV) PPIs utilization. Around 88% of patients were receiving PPIs for claimed stress ulcer prophylaxis (SUP) indication; of which, only 17% met the guideline criteria for SUP indication, 14% met the criteria for non-steroidal-anti-inflammatory drugs-induced ulcer prophylaxis, while the remaining 69% were identified as having an unjustified indication for PPI use. The initiation of IV PPIs was appropriate in 55% of patients. Half of these patients were candidates for switching to the oral dosage form during their hospitalization, while only 36.7% of these patients were actually switched. The inappropriate initiation of PPIs via the IV route was more likely to take place on the medical floor than the surgical floor (53% vs 36%, P = 0.003). The cost analysis associated with the appropriateness of the indication for PPI use as well as the route of administration of PPI revealed a possible saving of up to $17 732.5 and $14 571, respectively.
CONCLUSION: This study highlights the over-utilization of IV PPIs in non-intensive care unit patients. Restriction of IV PPI use for justified indications and route of administration is recommended.
Published
N/A
2015-10-01T10:20:29Z
2015-10-01T10:20:29Z
2010-02-28
2015-10-01
Article
1007-9327
http://hdl.handle.net/10725/2230
http://dx.doi.org/10.3748/wjg.v16.i8.982
Nasser, S. C., Nassif, J. G., & Dimassi, H. I. (2010). Clinical and cost impact of intravenous proton pump inhibitor use in non-ICU patients. World journal of gastroenterology: WJG, 16(8), 982.
http://www.wjgnet.com/1007-9327/full/v16/i8/982.htm
en
World Journal of Gastroenterology
oai:laur.lau.edu.lb:10725/22312016-08-22T10:47:28Zcom_10725_2058col_10725_2073
Treatment of mental disorders and pathways to care in Arab countries
Nasser, Soumana C.
Salamoun, Mariana M.
Introduction. The available studies on the treatment of mental disorders in the Arab world are uncommon. Methods. A literature review was conducted aiming at identifying studies related to the rate and type of treatment of mental disorders in Arab countries from the Middle Eastern Mediterranean region. Results. A total of 23 articles were included in this review. These articles focused mainly on type of services used and/ or the rate of treatment. Findings from several articles showed a paucity of treatment of mental disorders, and when present, individuals were more likely to receive it from the general medical than from the mental health sector. Only two studies have assessed patterns of treatment of mental disorders on a national level from the Arab Middle Eastern countries (Lebanon and Iraq). Conclusion. The need for national studies on mental disorders in this part of the world and the improvement of public awareness in this field were highlighted.
Published
N/A
2015-10-01T11:50:13Z
2015-10-01T11:50:13Z
2010-09-19
2015-10-01
Article
1365-1501
http://hdl.handle.net/10725/2231
http://dx.doi.org/10.3109/13651501.2010.512664
Nasser, S. C., & Salamoun, M. M. (2011). Treatment of mental disorders and pathways to care in Arab countries. International journal of psychiatry in clinical practice, 15(1), 12-18.
http://www.tandfonline.com/doi/abs/10.3109/13651501.2010.512664#.V6MCcbh97cs
en
International Journal of Psychiatry in Clinical Practice
oai:laur.lau.edu.lb:10725/22332019-03-04T13:18:18Zcom_10725_2058col_10725_2073
Dietary Calcium Intake of 1200 mg/d May Have Negative Correlation on Percent Body Fat
A Cross-sectional Study
Dimassi, Hani I.
Ghaddar, Sana H.
Bank, Laura S.
This cross-sectional study examined whether a correlation existed between calcium intake and body composition in 102 premenopausal Caucasian women. Data collected included 3 days of 24-hour food records, the Framingham Physical Activity instrument, and selected anthropometric and demographic information. Calcium intake was not statistically correlated with body composition. The high-calcium group (intake ≥1200 mg/d) had a significantly higher mean caloric intake (P ≤ .01) and significantly lower percent body fat (P ≤ .05) than the low-calcium group (intake <1200 mg/d). Based on our findings, there may be association between daily ingestion of at least 1200 mg of calcium and decreased percent body fat
N/A
N/A
2015-10-01T12:48:42Z
2015-10-01T12:48:42Z
2006
2015-10-01
Article
0883-5691
http://hdl.handle.net/10725/2233
Ghaddar, S. H., Dimassi, H. I., & Bank, L. S. (2006). Dietary Calcium Intake of 1200 mg/d May Have Negative Correlation on Percent Body Fat: A Cross‐sectional Study. Topics in Clinical Nutrition, 21(4), 284-292.
http://journals.lww.com/topicsinclinicalnutrition/Abstract/2006/10000/Dietary_Calcium_Intake_of_1200_mg_d_May_Have.5.aspx
en
Topics in Clinical Nutrition
oai:laur.lau.edu.lb:10725/22342016-12-05T10:24:03Zcom_10725_2058col_10725_2073
Stress ulcer prophylaxis guidelines
Are they being implemented in Lebanese health care centers?
Dimassi, Hani
Zeitoun, Abeer
Zeineddine, Maya
AIM: To evaluate the current practice of stress ulcer prophylaxis (SUP) in Lebanese Health care centers.
METHODS: A multi-center prospective chart review study was conducted over 8 mo. A questionnaire was distributed to pharmacy students who collected data on demographics, SUP medications, dose, route, duration and associated risk factors. The appropriateness of SUP use was determined as per American Society of Health-System Pharmacists guidelines. Institutional review board approval was obtained from each hospital center.
RESULTS: A total of 1004 patients were included. 67% of the patients who received prophylaxis did not have an indication for SUP. The majority (71.6%) of the patients who were administered parenteral drugs can tolerate oral medications. Overall, the regimen of acid-suppressant drugs was suboptimal in 87.6% of the sample. This misuse was mainly observed in non-teaching hospitals.
CONCLUSION: This study highlighted the need, in Lebanese hospitals, to establish clinical practice guidelines for the use of SUP; mainly in non-critical care settings.
Published
N/A
2015-10-01T13:05:06Z
2015-10-01T13:05:06Z
2011
2015-10-01
Article
2150-5349
http://hdl.handle.net/10725/2234
http://dx.doi.org/10.4292/wjgpt.v2.i4.27
Zeitoun, A., Zeineddine, M., & Dimassi, H. (2011). Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?. World journal of gastrointestinal pharmacology and therapeutics, 2(4), 27.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158880/
en
World Journal of Gastrointestinal Pharmacology and Therapeutics
oai:laur.lau.edu.lb:10725/22352016-12-02T11:22:38Zcom_10725_2058col_10725_2073
Lymph-node ratio is an independent prognostic factor in patients with stage III colorectal cancer
A retrospective study from the Middle East
Dimassi, Hani
Khalife, Mohammad
Elias, Elias
Mukherji, Deborah
Faraj, Walid
Eloubeidi, Mohamed
Shamseddine, Ali
Abou-Alfa, Ghassan K.
Saleh, Ahmad
Elias, E., Mukherji, D., Faraj, W., Khalife, M., Dimassi, H., Eloubeidi, M., ... & Shamseddine, A. (2012). Lymph-node ratio is an independent prognostic factor in patients with stage III colorectal cancer: a retrospective study from the Middle East. World J Surg Oncol, 10, 63.
Published
N/A
2015-10-01T13:26:52Z
2015-10-01T13:26:52Z
2012
2015-10-01
Article
1477-7819
http://hdl.handle.net/10725/2235
http://dx.doi.org/10.1186/1477-7819-10-63
Elias, E., Mukherji, D., Faraj, W., Khalife, M., Dimassi, H., Eloubeidi, M., ... & Shamseddine, A. (2012). Lymph-node ratio is an independent prognostic factor in patients with stage III colorectal cancer: a retrospective study from the Middle East. World J Surg Oncol, 10, 63.
http://wjso.biomedcentral.com/articles/10.1186/1477-7819-10-63
World Journal of Surgical Oncology
oai:laur.lau.edu.lb:10725/22362016-12-02T09:27:02Zcom_10725_2058col_10725_2073
Formulation Optimization Study for an Immediate-Release Tablet
Dimassi, Hani
Kyriacos, Soula
A simple method based on statistical analysis was used to optimize an immediate-release tablet formulation that includes a water-soluble drug. The objective of this study was to optimize different factors to develop a tablet formulation that has good tablet characteristics (hardness of 85 to 90 Newtons), disintegration time between 3 to 6 minutes, and friability <1%. The critical formulation/process factors were the type and concentration of microcrystalline cellulose, the ratio of lactose to microcrystalline cellulose, the concentration of croscarmellose, and the compression force. A two-step approach was implemented. First an optimization study was performed to determine the type of microcrystalline cellulose and its ratio to lactose. Subsequently, a final optimization formulation study was performed based on the results obtained in the preliminary study. Data were analyzed using the SPSS 15 (Statistical Software for Social Sciences). The differences in means between the formulation and the targeted product
Published
N/A
2015-10-02T06:13:33Z
2015-10-02T06:13:33Z
2009
2015-10-02
Article
1092-4221
http://hdl.handle.net/10725/2236
Kyriacos, S., & Dimassi, H. (2008). Formulation Optimization Study for an Immediate-Release Tablet. International journal of pharmaceutical compounding, 13(3), 259-261.
http://europepmc.org/abstract/med/23966482
en
International Journal of Pharmaceutical Compounding
oai:laur.lau.edu.lb:10725/22372016-12-02T11:41:35Zcom_10725_2058col_10725_2073
Occupational Violence at Lebanese Emergency Departments
Prevalence, Characteristics and Associated Factors
Dimassi, Hani
Alameddine, Mohamad
Kazzi, Amin
El-Jardali, Fadi
Maalouf, Salwa
Emergency departments (EDs) workers are at increased risk of exposure to occupational violence. The prevalence of occupational violence is potentially higher and consequences are more serious in areas with poor security conditions. Objectives: We investigated the prevalence, characteristics and factors associated with the exposure of ED workers to violence at Lebanese hospitals. Methods: All ED employees at six tertiary hospitals in Lebanon were surveyed using a cross-sectional design. The survey instrument included four sections collecting demographic/professional information and measuring exposure to violence, degree of job satisfaction and degree of professional burnout. The questionnaire was distributed to all ED employees at participating hospitals and was completed by 256 ED workers (70.3% response rate). Multinomial and binary logistic regressions were used to investigate factors significantly associated with verbal and physical violence. Results: Over the past 12 mo, four in five ED employees were verbally abused and one in four was physically assaulted. Exposure to verbal abuse was associated with serious outcomes including significantly higher levels of occupational burnout and an increased likelihood to quit current job. Exposure to physical violence was associated with increased likelihood-to-quit, nurse status and "public hospital" employment. Conclusion: Violence largely prevails at Lebanese EDs. Most vulnerable are nurses and employees of public hospitals who are disproportionally exposed to violence. ED stakeholders must work collaboratively to investigate the root causes of violence and devise and implement effective antiviolence policies and measures. Such measures will be necessary to protect the well-being and decrease the turnover of ED workers.
Published
N/A
2015-10-02T06:28:34Z
2015-10-02T06:28:34Z
2011
2015-10-02
Article
1341-9145
http://hdl.handle.net/10725/2237
http://doi.org/10.1539/joh.11-0102-OA
Alameddine, M., Kazzi, A., El-Jardali, F., Dimassi, H., & Maalouf, S. (2011). Occupational violence at Lebanese emergency departments: prevalence, characteristics and associated factors. Journal of occupational health, 53(6), 455-464.
https://www.jstage.jst.go.jp/article/joh/53/6/53_11-0102-OA/_article
https://www.jstage.jst.go.jp/article/joh/53/6/53_11-0102-OA/_article
en
Journal of occupational health
oai:laur.lau.edu.lb:10725/22382016-11-10T09:24:12Zcom_10725_2058col_10725_2073
NATIONAL VIEWPOINT-Practices in paediatric palliative care in Lebanon
Huijer, Huda Abu-Saad
Abboud, S.
Dimassi, Hani
Published
N/A
2015-10-02T06:41:55Z
2015-10-02T06:41:55Z
2008
2015-10-02
Article
1352-2779
http://hdl.handle.net/10725/2238
Huijer, H. A. S., Abboud, S., & Dimassi, H. (2008). NATIONAL VIEWPOINT-Practices in paediatric palliative care in Lebanon. European Journal of Palliative Care, 15(4), 190.
en
European Journal of Palliative Care
oai:laur.lau.edu.lb:10725/22392017-03-01T12:48:49Zcom_10725_2058col_10725_2073
The retention of health human resources in primary healthcare centers in Lebanon
A national survey
Dimassi, Hani
Alameddine, Mohamad
Saleh, Shadi
El-Jardali, Fadi
Mourad, Yara.
Background
Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon.
Methods
A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit.
Results
Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit.
Conclusions
The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should be dedicated to enhancing providers’ role satisfaction and sense of job security. Such initiatives are of pivotal importance to stabilize the workforce and ensure its longevity.
Published
N/A
2015-10-02T07:03:53Z
2015-10-02T07:03:53Z
2012
2015-10-02
Article
1472-6963
http://hdl.handle.net/10725/2239
http://dx.doi.org/10.1186/1472-6963-12-41
Alameddine, M., Saleh, S., El-Jardali, F., Dimassi, H., & Mourad, Y. (2012). The retention of health human resources in primary healthcare centers in Lebanon: a national survey. BMC health services research, 12(1), 419.
http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-419
en
BMC health services research
oai:laur.lau.edu.lb:10725/22402019-03-04T12:49:10Zcom_10725_2058col_10725_2073
Lymph Node Ratio Is an Independent Prognostic Factor After Resection of Periampullary Malignancies
Data From a Tertiary Referral Center in the Middle East
Dimassi, Hani
Shamseddine, Ali
Mukherji, Deborah
Melki, Christian
Elias, Elias
Eloubeidi, Mohammad
Objective: The prognostic impact of nodal involvement in resected pancreatic carcinoma and biliary malignancy has been relatively well established. It has been suggested that lymph node ratio (LNR) may be a more informative way of stratifying patients with node positive disease. Our retrospective review aimed to investigate the significance of such variables and test for independent prognostic factors for survival.
Methods: One hundred eighty-three pancreatic and periampullary malignancy cases were registered at the American University of Beirut Medical Center from 1990 to 2004. Of those, 80 had complete data on lymph node status. We analyzed the impact of the number of lymph nodes resected, the number of positive lymph nodes retrieved and LNR using Kaplan-Meier and Cox proportional hazard models. The measured outcome in the KM model was the survival probability at 1, 3, and 5 years while the Cox model was used to measure the hazard ratio (HR) of the previously identified predictors on survival.
Results: For the 80 patients included in this analysis, overall survival rates were 65% (54 to 78), 32% (18 to 47), and 21% (8 to 34) were alive at 1, 3, and 5 years, respectively. The median number of resected lymph nodes was 9. In the node positive patients, those who had >12 nodes examined were found to have a significantly better survival (HR=0.24; P=0.013). On multivariate analysis, our model showed the following factors to be significant: age 60 years or older (HR=5.92; P=0.018), poorly differentiated tumors (HR=21.87; P=0.018), number of lymph nodes examined <12 LN (HR=6.77; P=0.022), 3 or more metastatic LN (HR=7.21; P=0.028), and LNR≥0.2 (HR=7.12; P=0.007).
Conclusions: After pancreaticodudonectomy for adenocarcinoma of the pancreas and biliary malignancies, ratio-based lymph node staging is an independent and powerful prognostic factor.
Published
N/A
2015-10-02T08:34:16Z
2015-10-02T08:34:16Z
2014
2015-10-02
Article
0277-3732
http://hdl.handle.net/10725/2240
http://dx.doi.org/10.1097/COC.0b013e31826b9c74
Shamseddine, A. I., Mukherji, D., Melki, C., Elias, E., Eloubeidi, M., Dimassi, H., ... & Faraj, W. (2014). Lymph node ratio is an independent prognostic factor after resection of periampullary malignancies: data from a tertiary referral center in the middle East. American journal of clinical oncology, 37(1), 13-18.
http://journals.lww.com/amjclinicaloncology/Abstract/2014/02000/Lymph_Node_Ratio_Is_an_Independent_Prognostic.3.aspx
en
American Journal of Clinical Oncology.
oai:laur.lau.edu.lb:10725/22412019-03-21T09:32:05Zcom_10725_2058col_10725_2073
Perspectives on palliative care in Lebanon
Dimassi, Hani
Huijer, Huda Abu-Saad
Abboud, Sarah
Published
N/A
2015-10-02T09:28:07Z
2015-10-02T09:28:07Z
2008
2015-10-02
Article
1096-6218
http://hdl.handle.net/10725/2241
http://dx.doi.org/10.1089/jpm.2008.0128.
Huijer, H. A. S., Dimassi, H., & Abboud, S. (2008). Perspectives on Palliative Care in Lebanon. Journal of palliative medicine, 11(9), 1184-1185.
http://online.liebertpub.com/doi/abs/10.1089/jpm.2008.0128?journalCode=jpm
en
Journal of palliative medecine
oai:laur.lau.edu.lb:10725/22422022-03-08T12:20:59Zcom_10725_2058col_10725_2073
Acute pain management and assessment
are guidelines being implemented in developing countries (Lebanon)
Zeitoun, Abeer A.
Dimassi, Hani I.
Chami, Bahija A.
Chamoun, Nibal R.
Rationale Pain assessment and treatment is influenced by subjective perception of pain. Despite the international efforts to implement guidelines and protocols for pain management, pain continues to be regarded as a complication rather than a primary problem. The literature pertaining to the adequacy of pain management in the Middle East is frail. This study focuses on revealing the implemented practices of initial pain assessment, follow-up and re-evaluation of pain treatment in Lebanese hospitals.
Aim and objectives The objective of this study is to evaluate the presence and effectiveness of acute pain management and its impact on the quality of life in hospitals throughout Lebanon, in both cancer and non-cancer populations.
Methods A Lebanese multi-centre, prospective, chart review study was conducted over a period of 3 months. Data on demographics, pain medication, dose, route, duration and adjunct pain management were collected. Appropriateness of pain management was determined as per World Health Organization guidelines. Institutional Review Board approvals were obtained from each hospital.
Results Results from 582 participants revealed that 50% of initial pain assessment intensity scores were based on the assumptions of health care professionals. Furthermore, as pain severity scores increased, the adequacy of pain management decreased. Only 22% of the patients had a daily follow-up, and the majority of those continued to receive inappropriate therapy.
Conclusion This study reflects the lack of a well-structured system for pain management in Lebanese hospitals. It underlines the need for pain research in the region. It also highlights the need for implementing the recommendations discussed to minimize risk and optimize pain management.
Published
N/A
2015-10-02T10:02:05Z
2015-10-02T10:02:05Z
2012
2015-10-02
Article
1365-2753
http://hdl.handle.net/10725/2242
http://dx.doi.org/10.1111/j.1365-2753.2012.01860.x
Zeitoun, A. A., Dimassi, H. I., Chami, B. A., & Chamoun, N. R. (2013). Acute pain management and assessment: are guidelines being implemented in developing countries (Lebanon). Journal of Evaluation in Clinical Practice, 19(5), 833-839.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2753.2012.01860.x
Journal of Evaluation in Clinical Practice
oai:laur.lau.edu.lb:10725/22512016-08-22T08:57:57Zcom_10725_2058col_10725_2073
Otitis media with effusion in Lebanese children
prevalence and pathogen susceptibility
Nasser, Soumana
Moukarzel, N.
Nehme, A.
Haidar, H.
Kabbara, B.
Haddad, A.
Objective: To determine the prevalence and resistance profile of bacterial pathogens present in the middle ear of
children with otitis media with effusion, and to report beta-lactamase-negative, ampicillin-resistant bacteria for
the first time in Lebanese children.
Method: We included 62 patients younger than 12 year (107 ears), who underwent myringotomy with
tympanostomy tube placement for persistent otitis media with effusion. Bacteria were identified by Gram
staining and biochemical tests, and antibiotic sensitivities tested by the disc diffusion method and via minimum
inhibitory concentration (E-test).
Results: The commonest pathogen was Haemophilus influenzae (62 per cent), followed by Streptococcus
pneumoniae (26 per cent). The H influenzae resistance profile was highest for amoxicillin (81.0 per cent) and
lowest for cefotaxime (19.0 per cent). There was a high risk of developing H influenzae antibiotic resistance
among children with a history of smoking exposure (p = 0.001), recurrent upper respiratory tract infection (p =
0.001) or previous antibiotic treatment (p = 0.005). Fifty-two per cent of H influenzae colonies were found to
be beta-lactamase-negative and ampicillin-resistant.
Conclusion: In these children with persistent otitis media with effusion, H influenzae was the most prevalent
bacteria. It showed a high incidence of resistance to the antibiotics most commonly prescribed to treat acute
otitis media.
Published
N/A
2015-10-05T08:33:42Z
2015-10-05T08:33:42Z
2011
2015-10-05
2011
Article
0022-2151
http://hdl.handle.net/10725/2251
http://dx.doi.org/10.1017/S0022215111001587
Nasser, S. C., Moukarzel, N., Nehme, A., Haidar, H., Kabbara, B., & Haddad, A. (2011). Otitis media with effusion in Lebanese children: prevalence and pathogen susceptibility. The Journal of Laryngology & Otology, 125(09), 928-933.
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8354134&fileId=S0022215111001587
en
The Journal of Laryngology & Otology
oai:laur.lau.edu.lb:10725/22522021-03-19T09:59:47Zcom_10725_2058col_10725_2073
Cost reduction associated with restriction policy on dispensing intravenous esomeprazole in lebanon
Nasser, Soumana C.
Nassif, Jeanette G.
Mahfouz, Fouad
Objectives To assess the impact of the pharmacist on cost through simple implementation of restriction policy on IV drug usage during pharmacy dispensing procedure. Setting In-patient floors of a Hospital. Methods All medication orders for IV esomeprazole, received at the pharmacy during a 24-month period, were reviewed for appropriate IV route of administration. Two separate time intervals, pre- and post- implementation of restriction dispensing policy, were used to determine cost impact of pharmacy intervention. Main Outcome Measure The cost difference between pre- and post-restriction periods. Results During the pre-restriction period, the majority of esomeprazole IV vials were dispensed to patients able to tolerate oral medications and who were admitted to non-intensive care units. The average monthly consumption of IV esomeprazole was 1,439 vials in the pre-restriction period as compared to 346 vials in the post-restriction period. Therefore, the associated cost was reduced by an average of $21,233 per month. Conclusion Even though the clinical role of pharmacy practice in Middle Eastern countries is limited, this study highlighted the impact of the pharmacist on cost through the implementation of restriction policy during dispensing procedure, leading to a cost reduction by four folds.
Published
N/A
2015-10-06T06:01:05Z
2015-10-06T06:01:05Z
2010-11-04
2016-05-09
Article
0928-1231
http://hdl.handle.net/10725/2252
http://dx.doi.org/10.1007/s11096-010-9451-4
Nasser, S. C., Nassif, J. G., & Mahfouz, F. (2010). Cost reduction associated with restriction policy on dispensing intravenous esomeprazole in lebanon. Pharmacy world & science, 32(6), 707-710.
http://link.springer.com/article/10.1007/s11096-010-9451-4
en
Pharmacy World & Science
oai:laur.lau.edu.lb:10725/22572016-08-22T08:14:59Zcom_10725_2058col_10725_2073
Palliative Tumor Control by Trabectedin in Pediatric Advanced Sarcoma
Nasser, Soumana C.
Farah, Roula A.
Sabbagh, Racha A.
Dina, Pele B.
Eid, Toufic A.
Refractory soft tissue sarcomas carry a poor prognosis and limited treatment options require the use of new chemotherapeutic agents. We report the case of an eight year old boy with non metastatic alveolar rhabdomyosarcoma of the right forearm (Group 3, Stage III). After treatment failure of several chemotherapeutic regimens and progression of his disease, Trabectedin was administered at 1.3 mg/m2/dose intravenously over 24 hours for two cycles. The patient's quality of life improved as noted by a significant decrease in opiate requirements and ability to tolerate oral intake. The drug was well tolerated with the exception of transient neutropenia.
Published
N/A
2015-10-06T08:59:01Z
2015-10-06T08:59:01Z
2011-05-02
2015-10-06
Article
1574-8855
http://hdl.handle.net/10725/2257
http://dx.doi.org/10.2174/157488511795304912
A Farah, R., C Nasser, S., A Sabbagh, R., B Dina, P., & A Eid, T. (2011). Palliative Tumor Control by Trabectedin in Pediatric Advanced Sarcoma. Current Drug Therapy, 6(2), 97-99.
http://www.ingentaconnect.com/content/ben/cdth/2011/00000006/00000002/art00003
en
Current Drug Therapy
oai:laur.lau.edu.lb:10725/22592016-08-22T10:13:30Zcom_10725_2058col_10725_2073
A guide on Intravenous drug compatibilities based on their pH
Nasser, Soumana C.
Loubnan, Vilma
Hospital pharmacies in many countries include a mix of both European and FDA approved medications in their Formulary. Mixing incompatible medications is a major intravenous (IV) medication error especially when data on compatibility is not available in commonly used references. The pH of IV medications is very important to consider when tackling compatibility of solutions. Developing a guide reporting the pH of medications, in addition to compatible solutions and light sensitivity, can serve as a unique tool during the preparation of special admixture for a specific patient.
Published
N/A
2015-10-06T09:32:13Z
2015-10-06T09:32:13Z
2010-12
2015-10-06
Article
0976-8157
http://hdl.handle.net/10725/2259
Loubnan, V., & Nasser, S. C. (2010). A guide on intravenous drug compatibilities based on their pH. Pharmacie Globale (IJCP), 5(01), 1-9.
https://www.researchgate.net/profile/Soumana_Nasser/publication/49596162_Review_A_GUIDE_ON_INTRAVENOUS_DRUG_COMPATIBILITIES_BASED_ON_THEIR_pH/links/54fca7600cf270426d102bab.pdf
en
Pharmacie Globale: International Journal of Comprehensive Pharmacy
oai:laur.lau.edu.lb:10725/23232024-01-31T15:13:50Zcom_10725_2056com_10725_2058com_10725_2053col_10725_2077col_10725_2073col_10725_2071
Growth hormone treatment modulates active ghrelin levels in rats
Haddad, Haytham
Mroueh, Mohamad
Faour, Wissam H.
Daher, Costantine
Introduction: Impairments in neuroendocrine regulation of food intake and postprandial satiety are leading causes to obesity. Ghrelin peptide is a GI hormone known to increase food intake partly through induction of growth hormone. The regulation of ghrelin production is still unknown. Objective: The aim of the current study is to investigate the influence of growth hormone (Genotropin) treatment on active ghrelin levels in plasma, stomach, pancreas and kidney in rats. Material/methods: Male Sprague-Dawley rats, randomly allocated into control and three treatment groups, received daily subcutaneous injections of Genotropin at 2, 20 and 100 µg/rat/day for 5 consecutive days. Active ghrelin levels were quantified per tissue mass or tissue protein. Results: In control groups, the highest active ghrelin concentration in pmol/g tissue was found in the stomach (15.5 ± 0.21) followed by the pancreas (1.96 ± 0.066) and the kidney (1.36 ± 0.037). Genotropin treatment caused a dose dependent decrease in active ghrelin concentration in stomach, kidney and pancreas with a concomitant increase in plasma, and reaching significance at 20 and 100 µg/rat/day doses. However, the treatment caused variable effect on total protein concentrations, with a decrease in pancreas and an increase in stomach and kidney supernatants. Consequently, under such treatment, determination of active ghrelin concentration per tissue mass rather than per tissue protein is favored. Conclusions: The present study suggests a direct correlation between Genotropin treatment and active ghrelin secretion into the rat plasma via modulating its stores in stomach, kidney and pancreas.
Published
N/A
2015-10-23T09:07:18Z
2015-10-23T09:07:18Z
2014
2015-10-23
Article
0743-5800
http://hdl.handle.net/10725/2323
http://dx.doi.org/10.3109/07435800.2013.799484
Haddad, H., Mroueh, M., Faour, W. H., & Daher, C. (2014). Growth hormone treatment modulates active ghrelin levels in rats. Endocrine research, 39(1), 39-43.
http://www.tandfonline.com/doi/abs/10.3109/07435800.2013.799484
en
Endocrine Research
oai:laur.lau.edu.lb:10725/24332024-01-31T13:20:10Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
The antioxidant and anticancer effects of Wild Carrot oil extract
Shebaby, Wassim Nasri
El-Sibai, Mirvat
Bodman-Smith, Kikki
Karam, Marc Christoph
Mroueh, Mohamad
Daher, Costantine F.
Daucus carota L. ssp. carota (Apiacea) is used in traditional medicine in Lebanon and in different regions throughout the world. The present study investigates the in vitro anticancer activities of Daucus carota oil extract (DCOE) on four human cancer cell lines as well as its in vitro antioxidant activity. DCOE was extracted from the dried umbels with 50:50 acetone-methanol. The oil extract was analyzed by gas chromatography–mass spectrometry and screened for its antioxidant properties in vitro using 1,1-diphenyl-2-picryl hydrazyl free radical scavenging assay (DPPH), ferrous ion chelating assay (FIC) and the ferric reducing antioxidant power assay (FRAP). The anticancer activity of the oil extract against human colon (HT-29, Caco-2) and breast (MCF-7, MDA-MB-231) cancer cell lines was evaluated using the trypan blue exclusion method and the WST-1 cell proliferation assay. DCOE exhibited antioxidant activity in all assays used. The FRAP value was 164 ± 5.5 µmol FeSO4/g, and the IC50 values for DPPH and FIC assays were 2.1 ± 0.03 mg/ml and 0.43 ± 0.02 mg/ml, respectively. Also, DCOE demonstrated a significant increase in cell death and decrease in cell proliferation. The effect of DCOE on the cell lines exhibited time and dose-dependent responses. The present study established that DCOE possesses both antioxidant and promising anticancer activities.
Published
N/A
2015-11-04T11:14:39Z
2015-11-04T11:14:39Z
2012-07-20
2015-11-04
Article
0951-418X
http://hdl.handle.net/10725/2433
http://dx.doi.org/10.1002/ptr.4776
Shebaby, W. N., El‐Sibai, M., Smith, K. B., Karam, M. C., Mroueh, M., & Daher, C. F. (2013). The antioxidant and anticancer effects of wild carrot oil extract. Phytotherapy Research, 27(5), 737-744.
http://onlinelibrary.wiley.com/doi/10.1002/ptr.4776/full
en
Phytotherapy Research
oai:laur.lau.edu.lb:10725/24852024-01-31T15:34:48Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Metal Concentration in Commonly Used Medicinal Herbs and
Infusion by Lebanese Population: Health Impact
Korfali, Samira I.
Mroueh, Mohamad
Al Zein, Mohammad
Salim, Rosin
The levels of K, Ca, Fe, Zn, Cu, Mn, Pb, As, Cd, Cr, and Pb in commonly used medicinal herbs and their infusions by Lebanese were analyzed by EDXRF and ASS techniques, respectively. The order of metal contents in the herbs was found to be: K (6990-19850 ug/g) > Ca(1630-14450 ug/g) > Fe(80-3650 ug/g) > Mn (28-458 ug/g) > Zn (23-108 ug/g) > Cu (5-71 ug/g) > Cr (3.1-55 ug/g) Pb> (1.1-10.3 ug/g) > As (nd-10.8 ug/g) > Cd (nd-1.7 ug/g). The mean levels of toxic metals in herbs Pb, As and Cd were below WHO permissible levels. Cluster analysis indicated metals are most probably in plants due to wastes disposal and irrigation with contaminated wastes and/or from atmospheric waste particulates. The levels of Mn, Cr, Pb and As in herbal infusions were found to be higher in soaked than boiled preparations and correlated with Fe, while Zn and Cu levels were higher in boiled infusions. The highest weekly intake from herbal infusions of toxic metals Cr (492.8 ug), As (77.0 ug), Pb (291.2 ug) and Cd (19.0 ug) were below the recommended permissible tolerable weekly intake respectively 1260 ug, 900 ug, 1500 ug, and 150 ug. Therefore, the consumption of these traditional medicinal herbs does not pose any health risk provided full compliance with recommended daily doses.
Published
N/A
2015-11-07T14:52:08Z
2015-11-07T14:52:08Z
2013
2015-11-07
Article
1927-0887
http://hdl.handle.net/10725/2485
http://dx.doi.org/10.5539/jfr.v2n2p70
Korfali, S. I., Mroueh, M., Al-Zein, M., & Salem, R. (2013). Metal concentration in commonly used medicinal herbs and infusion by Lebanese population: health impact. Journal of Food Research, 2(2), p70.
http://search.proquest.com/openview/e31cf6c868db54e99a6d71812cd94350/1?pq-origsite=gscholar
en
Journal of Food Research
oai:laur.lau.edu.lb:10725/24862024-01-31T15:10:18Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Evaluation of heavy metals content in dietary supplements in Lebanon
Korfali, Samira Ibrahim
Hawi, Tamer
Mroueh, Mohamad
Background: The consumption of dietary supplements is widely spread and on the rise. These dietary supplements
are generally used without prescriptions, proper counseling or any awareness of their health risk. The current study
aimed at analyzing the metals in 33 samples of imported dietary supplements highly consumed by the Lebanese
population, using 3 different techniques, to ensure the safety and increase the awareness of the citizen to benefit
from these dietary supplements.
Results: Some samples had levels of metals above their maximum allowable levels (Fe: 24%, Zn: 33%, Mn: 27%, Se:
15%, Mo: 12% of samples), but did not pose any health risk because they were below permitted daily exposure
limit and recommended daily allowance except for Fe in 6% of the samples. On the other hand, 34% of the
samples had Cu levels above allowable limit where 18% of them were above their permitted daily exposure and
recommended daily allowance. In contrast, all samples had concentration of Cr, Hg, and Pb below allowable limits
and daily exposure. Whereas, 30% of analyzed samples had levels of Cd above allowable levels, and were
statistically correlated with Ca, and Zn essential minerals. Similarly 62% of the samples had levels of As above
allowable limits and As levels were associated with Fe and Mn essential minerals.
Conclusion: Dietary supplements consumed as essential nutrients for their Ca, Zn, Fe and Mn content should be
monitored for toxic metal levels due to their natural geochemical association with these essential metals to provide
citizens the safe allowable amounts.
Published
N/A
2015-11-07T14:59:33Z
2015-11-07T14:59:33Z
2013
2015-11-07
Article
1895-1066
http://hdl.handle.net/10725/2486
http://dx.doi.org/10.1186/1752-153X-7-10
Korfali, S. I., Hawi, T., & Mroueh, M. (2013). Evaluation of heavy metals content in dietary supplements in Lebanon. Chem Cent J, 7(10).
http://ccj.springeropen.com/articles/10.1186/1752-153X-7-10
en
Chemistry Central Journal
oai:laur.lau.edu.lb:10725/26522016-10-13T05:49:38Zcom_10725_2058col_10725_2073
Hepatoprotective activity of Centaurium erythraea on acetaminophen‐induced hepatotoxicity in rats
Mroueh, Mohamad
Saab, Yolande
Rizkallah, Raed
The methanol extract of the leaves of Centaurium erythraea L. (Gentianaceae) was evaluated for hepatoprotective activity against acetaminophen-induced liver toxicity in rats. An oral dose of 300 mg/kg/day for 6 days or a single dose of 900 mg/kg for 1 day exhibited a significant protective effect by lowering serum glutamate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT) and lactate dehydrogenase (LDH). The activity of the extract was supported by histopathological examination of liver sections.
Published
N/A
2015-11-20T10:32:13Z
2015-11-20T10:32:13Z
2004-05-26
2015-11-20
Article
0951-418X
http://hdl.handle.net/10725/2652
http://dx.doi.org/10.1002/ptr.1498
Mroueh, M., Saab, Y., & Rizkallah, R. (2004). Hepatoprotective activity of Centaurium erythraea on acetaminophen‐induced hepatotoxicity in rats. Phytotherapy Research, 18(5), 431-433.
http://onlinelibrary.wiley.com/doi/10.1002/ptr.1498/abstract
en
Phytotherapy Research
oai:laur.lau.edu.lb:10725/26842024-01-31T15:41:40Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
The Potential Role of Daucus carota Aqueous and Methanolic Extracts on Inflammation and Gastric Ulcers in Rats
Wehbe, Katia
Mroueh, Mohamad
Daher, Costantine F.
Daucus carota (DC) is among commonly used plants in folk medicine in Lebanon and the region. The present investigation was undertaken to examine the effects of the aqueous and extracts of Daucus carota umbels against acute and chronic inflammation, gastric ulcer and antibacterial activity on rats. The effects of DC aqueous extract (DCAE) on glycemia, lipemia, hepatic, renal and pancreatic function were also examined. Results on acute inflammation showed that the aqueous and methanolic extracts (DCME) produced maximum anti-inflammatory activity at doses of 400 and 140 mg/kg body weight with 90.9 and 58.6 % inhibition, respectively. In chronic inflammation, the same doses showed maximum anti-inflammatory activity with 58 and 44.1 % inhibition, respectively. DCME showed significant protection against ethanol induced gastric ulcer with a curative ratio of 46.8 and 68.7%, respectively, at a dose of 250 mg/kg body weight. None of the extracts showed significant antibacterial activity. DCAE intake (250 mg/kg body weight) for one month period did not show adverse effects on lipemia, glycemia, hepatic and liver function except for a slight decrease in HDL cholesterol (p<0.05). In conclusion, both DCAE and DCME exhibited promising anti-inflammatory and anti-ulcerogenic potentials while showing no negative influence on liver, kidney and pancreas function.
Published
N/A
2015-11-25T10:20:38Z
2015-11-25T10:20:38Z
2009
2015-11-25
Article
2194-6329
http://hdl.handle.net/10725/2684
http://dx.doi.org/10.2202/1553-3840.1159
Wehbe, K., Mroueh, M., & Daher, C. F. (2009). The potential role of Daucus carota aqueous and methanolic extracts on inflammation and gastric ulcers in rats. Journal of Complementary and Integrative Medicine, 6(1).
https://www.degruyter.com/document/doi/10.2202/1553-3840.1159/html
en
Journal of Complementary and Integrative Medicine
oai:laur.lau.edu.lb:10725/26862024-01-31T15:26:01Zcom_10725_2058col_10725_2073
Levels of benzoic and sorbic acid preservatives in commercially produced yoghurt in Lebanon
Mroueh, Mohamad
Issa, Dina
Khawand, Jesele
Haraty, Bassam
Malek, Amal
Kassaify, Zeina
Toufeili, Imad
Benzoic and sorbic acids and their salts are extensively used in the preservation of foods. Their levels of use in different food products are regulated
by national and international regulatory agencies. Benzoic acid occurs naturally in yoghurt and no reference exists as to its deliberate use in the
preservation of this cultured dairy product. Sorbic acid levels up to 1000 mg kg-1 are allowed by country regulations in yoghurt production
presumably to ensure a reasonable commercial shelf life. High-performance liquid chromatography (HPLC) is extensively used in the determination
of benzoate and sorbate in foods. Thirty samples of commercial yoghurt, produced in Lebanon, were analysed by HPLC for their contents of
benzoic and sorbic acids. All samples contained benzoic acid with levels ranging between 12 and 479.1 mg kg-1 and 14 samples contained in addition
sorbic acid amounts in the range of 83.9 and 3719.1 mg kg-1. Indigenous benzoic acid levels in laboratory-produced yoghurt, under aseptic
conditions, ranged between 5.5 and 14.7 mg kg-1 after storage for 4 weeks. The results indicate that benzoic acid levels higher than those could be
attributed to the microbial activity of the starter cultures and sorbic acid amounts higher than those set by regulatory agencies are used in yoghurt
production. Application of good manufacturing practices by dairy processors and closer monitoring of preservatives levels by regulatory agencies
are warranted to reduce levels of usage of benzoic and sorbic acids in yoghurt production.
Published
N/A
2015-11-25T10:34:56Z
2015-11-25T10:34:56Z
2008
2016-05-19
Article
2342-0308
http://hdl.handle.net/10725/2686
Mroueh, M., Issa, D., Khawand, J., Haraty, B., Malek, A., Kassaify, Z., & Toufeili, I. (2008). Levels of benzoic and sorbic acid preservatives in commercially produced yoghurt in Lebanon. Journal of food agriculture and environment, 6(1), 62.
http://world-food.net/download/journals/2008-issue_1/f11.pdf
en
Journal of Food, Agriculture & Environment
oai:laur.lau.edu.lb:10725/26882024-01-31T15:22:35Zcom_10725_2058col_10725_2073
In Vitro Testing of Ciprofloxacin Formulations and Preliminary Study on BCS Biowaiver
Kyriacos, Soula Boustani
Boukarim, Chawki
Safi, William
Mroueh, Mohamad
Maroun, Aline Bou
El-Khoury, Ghada
Shehayeb, Rabih
The purpose of this study was to compare the technical quality of ciprofloxacin tablets and examine the feasibility of biopharmaceutical classification system (BCS) biowaiver. Ciprofloxacin is a synthetic quinolone derivative anti-infective agent that has been classified as a Class 3 substance according to the biopharmaceutics classification system. Due to the importance of ciprofloxacin
as an antibiotic for widely resistant bacteria and the importance of price in a community basis, different ciprofloxacin products available on the market were analyzed. The possibility of extending biowaivers to ciprofloxacin was also examined. Waiver for Class 2 and Class 3 drugs is sometimes scientifically justified. Ciprofloxacin has properties that are intermediate between BCS Classes 2 and 3, as the drug is highly soluble below pH 6 and poorly soluble above this pH. Ten generic brands and the innovator brand were compared on friability, hardness, average weight, content uniformity, disintegration and dissolution. In vitro testing indicates significant variations among some brands in terms of hardness, disintegration and dissolution. Dissolution testing met pharmacopeial requirements for all brands. However, significant variations in dissolution profiles were observed in 0.1N HCl and in phosphate buffer (pH 6.8) with no difference detected in acetate buffer (pH 4.5). The results suggest that the formulation and/or the manufacturing process affect the dissolution and thus the bioavailability of the drug products. The significance of the observed in
vitro differences must be confirmed by an in vivo bioequivalence study.
Published
N/A
2015-11-25T10:49:57Z
2015-11-25T10:49:57Z
2009
2015-11-25
Article
1021-9498
http://hdl.handle.net/10725/2688
https://doi.org/10.38212/2224-6614.2298
Kyriacos, S. B., Boukarim, C., Safi, W., Mroueh, M., Maroun, A. B., El-Khoury, G., & Shehayeb, R. (2009). In vitro testing of ciprofloxacin formulations and preliminary study on BCS biowaiver. Journal of food and drug analysis, 17(2).
https://www.jfda-online.com/journal/vol17/iss2/10/
en
Journal of Food and Drug Analysis
oai:laur.lau.edu.lb:10725/27402024-02-01T13:33:42Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Wild carrot oil extract is selectively cytotoxic to human acute myeloid leukemia cells
Tawil, Mirna
Bekdash, Amira
Mroueh, Mohamad
Daher, Costantine F.
Abi-Habib, Ralph J.
In this study, we used Daucus carota oil extract (DCOE) to target acute myeloid leukemia (AML) cells. All the AML cell lines tested were sensitive to the extract while peripheral mononuclear cells were not. Analysis of mechanism of cell death showed an increase in cells positive for annexinV and for active caspases, indicating that DCOE induces apoptotic cell death in AML. Inhibition of the MAPK pathway decreased sensitivity of AML cells to DCOE, indicating that cytotoxicity may be dependent on its activity. In conclusion, DCOE induces selective apoptosis in AML cells, possibly through a MAPK-dependent mechanism.
Published
N/A
2015-12-01T07:56:56Z
2015-12-01T07:56:56Z
2015
2015-12-01
Article
1513-7368
http://hdl.handle.net/10725/2740
http://dx.doi.org/10.7314/APJCP.2015.16.2.761
Tawil, M., Bekdash, A., Mroueh, M., Daher, C. F., & Abi-Habib, R. J. (2014). Wild Carrot Oil Extract is Selectively Cytotoxic to Human Acute Myeloid Leukemia Cells. Asian Pacific journal of cancer prevention: APJCP, 16(2), 761-767.
https://pubmed.ncbi.nlm.nih.gov/25684522/
en
Asian Pacific Journal of Cancer Prevention
oai:laur.lau.edu.lb:10725/27432024-01-31T15:38:15Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon
Hage-Sleiman, Rouba
Mroueh, Mohamad
Daher, Costantine F.
Context: Althaea officinalis Linn. (Malvaideae) flower is commonly used in folk medicine in Lebanon and neighboring countries. Although most of the studies have been conducted on the mucilage-rich roots, little is known about the flower.
Objective: This study investigates the potential role of aqueous extract of Althaea officinalis flower in lipemia, gastric ulcer, inflammation, and platelet aggregation using the rat model.
Material and Methods: Blood lipid profile and liver function were assessed after 1 month of extract intake via drinking water. Anti-inflammatory activity was tested against acute and chronic inflammation induced by carrageenan and formalin, respectively. Antiulcer activity was evaluated using ethanol-induced gastric ulcer. Antiplatelet activity was investigated in vitro using the adenosine 5′-diphosphate (ADP)-induced platelet aggregation bioassay.
Results: The 50 mg/kg body weight dose resulted in significant increase in serum HDL cholesterol level with no effects on stool cholesterol and triacylglycerol. Increasing the dose to 500 mg/kg body weight caused a significant decrease in stool water content. No adverse effect on liver enzymes was observed. Significant anti-inflammatory (acute and chronic inflammation) and antiulcerogenic activities were observed at all used doses (50, 100, and 250 mg/kg body). Time-dependent inhibition of platelet aggregation was demonstrated at 500 µg/ml concentration.
Discussion and conclusion: The aqueous extract of Althaea officinalis flower demonstrated potential benefits in lipemia, inflammation, gastric ulcer, and platelet aggregation with no visible adverse effect.
Published
N/A
2015-12-01T08:30:52Z
2015-12-01T08:30:52Z
2011-02-01
2015-12-01
Article
1388-0209
http://hdl.handle.net/10725/2743
http://dx.doi.org/10.3109/13880209.2010.516754
Hage-Sleiman, R., Mroueh, M., & Daher, C. F. (2011). Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharmaceutical biology, 49(3), 327-333.
http://www.tandfonline.com/doi/abs/10.3109/13880209.2010.516754
en
Pharmaceutical Biology
oai:laur.lau.edu.lb:10725/27452024-01-31T14:44:33Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
Chemopreventive effects of wild carrot oil against 7,12-dimethyl benz(a)anthracene-induced squamous cell carcinoma in mice
Abu Zeinab, Rami
Mroueh, Mohamad
Diab-Assaf, Mona
Jurjus, Abdo
Wex, Brigitte
Sakr, Amer
Daher, Costantine F.
Context: Daucus carota L. ssp. carota (Apiacea) is widely distributed throughout the world and has many uses in traditional medicine.
Objective: The present study investigates the chemopreventive effects of oil extract of D. carota umbels on 7,12-dimethyl benz(a)anthracene (DMBA)-induced skin cancer in mice.
Materials and methods: D. carota oil extract (DCOE) was prepared by extracting the dried umbels with 50:50 acetone:methanol. Skin papilloma were initiated by DMBA and promoted by 12-O-tetradecanoyl phorobol-13-acetate (TPA). The extract was administered to animals via gavage (0.02 mL of 100% oil), intraperitoneal (0.3 mL of 2% oil), and topical (0.2 mL of 5, 50, and 100% oil) routes for 20 weeks. Tumor appearance, incidence, yield, and volume were compared with those of a non-treated control group.
Results: Topical 100% treatment delayed tumor appearance, and inhibited tumor incidence and yield by 40 and 89%, respectively. Topical 50% treatment inhibited tumor incidence and yield by 30 and 83%, respectively, whereas the 5% treatment inhibited tumor yield by 36%. Tumor volume was decreased by 99, 91, and 70% following topical treatments with 100, 50, and 5% oil, respectively. Intraperitoneal treatment inhibited tumor yield by 43%, and decreased tumor volume by 85%, whereas gavage treatment showed minimal effects on both. Intraperitoneal and topical treatment decreased infiltration and hyperplasia with an increase in the level of hyperkeratosis.
Conclusion: These findings demonstrate that DCOE has remarkable antitumor activity against DMBA-induced skin cancer compared with non-treated animals paving the ground for further investigations.
Published
N/A
2015-12-01T08:58:50Z
2015-12-01T08:58:50Z
2011-07-21
2015-12-01
Article
1388-0209
http://hdl.handle.net/10725/2745
http://dx.doi.org/10.3109/13880209.2011.559250
Zeinab, R. A., Mroueh, M., Diab-Assaf, M., Jurjus, A., Wex, B., Sakr, A., & Daher, C. F. (2011). Chemopreventive effects of wild carrot oil against 7, 12-dimethyl benz (a) anthracene-induced squamous cell carcinoma in mice. Pharmaceutical biology, 49(9), 955-961.
http://www.tandfonline.com/doi/abs/10.3109/13880209.2011.559250
en
Pharmaceutical Biology
oai:laur.lau.edu.lb:10725/27462024-01-31T15:48:31Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
The role of methanolic extract of Quercus infectoria bark in lipemia, glycemia, gastric ulcer and bacterial growth
Khouzami, L.
Mroueh, Mohamad
Daher, Costantine F.
Nowadays, the surge of consumption of herbal supplements is encouraged by several factors, including the common belief that all herbal products are relatively safe and effective. The present investigation explores the effects of methanolic extract of Quercus infectoria bark upon rat blood lipid profile, glycemia, inflammation, gastric ulcer and bacterial growth. After one month of chronic extract (0.5% w/v) intake via drinking water, there was a significant increase in serum HDL-cholesterol level. This was accompanied with an increase in both serum glucose and insulin levels. No significant changes were observed in other lipid parameters studied. Liver enzyme activities as well as urea and creatinine levels were not negatively affected. Extract at 250, 500 and 1000 mg/kg body weight exhibited substantial anti-inflammatory effects in cases of acute and chronic inflammation induced by carrageenan and formalin respectively. Pre-treatment of fasted rats with the extract (100 and 500 mg/kg body weight) also demonstrated significant protection against ethanol-induced gastric ulcer. Antibacterial activity against Proteus mirabilis, Citrobacter braaki, and Staphylococcus aureus methicillin resistant and sensitive was also noticed. In conclusion, these findings suggest that the methanolic extract of Q. infectoria bark provides an inexpensive and powerful source of herbal supplement used to treat various conditions.
Published
N/A
2015-12-01T09:23:07Z
2015-12-01T09:23:07Z
2009
2015-12-01
Article
1996-0875
http://hdl.handle.net/10725/2746
Khouzami, L., Mroueh, M., & Daher, C. F. (2009). The role of methanolic extract of Quercus infectoria bark in lipemia, glycemia, gastric ulcer and bacterial growth. Journal of Medicinal Plants Research, 2(4), 224-30.
http://www.academicjournals.org/journal/JMPR/article-abstract/4A409D415000
en
Journal of Medicinal Plants Research
oai:laur.lau.edu.lb:10725/27472016-08-23T05:42:11Zcom_10725_2058col_10725_2073
Cytochrome P450 2D6 polymorphism in white Lebanese population
Saade, Sarita
Mroueh, Mohamad
Saab, Yolande
Objective: Genetic, environmental, physiological and pathophysiological factors contribute to the interindividual variability in drug metabolism and response. Among the different cytochromes responsible for drug disposition, cytochrome P450 2D6 (CYP2D6) is a polymorphic enzyme accountable for the clearance of 25% to 30% of medications used including cardiovascular and neuroactive drugs. Severe clinical implications can result from CYP2D6 polymorphism, hence the significance of studying the incidence of different phenotypes in the white Lebanese population.
Methods: A 30-mg dose of dextromethorphan hydrobromide was administered to 156 volunteers. Urine samples were collected 8 hours after dextromethorphan administration then stored at -80[degrees]C until analysis for dextromethorphan levels and its metabolites using a sensitive, simple high-performance liquid chromatography assay.
Results: The distribution frequency histogram of CYP2D6 metabolic ratios (MRs) showed a bimodal distribution with a gap between the metabolic ratios of 0.14 and 0.31 corresponding to log MR between -0.85 and -0.51. This gap correlates well with the antimode of MR=0.3 reported by previous studies in white populations. Sixteen subjects were classified as poor metabolizers accounting for 10.25% of the whole population sample with metabolic ratios ranging from 0.31 to 25.77; in contrast, 140 (89.75%) volunteers were found to be extensive metabolizers exhibiting MRs between 0.000439 and 0.139.
Conclusions: The findings demonstrated the presence of a high proportion of CYP2D6 poor metabolizers in the white Lebanese population and hence the significance of potential clinical implications in these subjects.
Published
N/A
2015-12-01T12:23:54Z
2015-12-01T12:23:54Z
2006-03-01
2015-12-01
Article
1537-064X
http://hdl.handle.net/10725/2747
Saade, S., Mroueh, M., & Saab, Y. (2006). Cytochrome P450 2D6 Polymorphism in White Lebanese Population. JOURNAL OF APPLIED RESEARCH IN CLINICAL AND EXPERIMENTAL THERAPEUTICS, 6(1), 89.
http://www.biomedsearch.com/article/Cytochrome-P450-2D6-polymorphism-in/159491758.html
en
Journal of Applied Research
oai:laur.lau.edu.lb:10725/27492024-01-31T15:45:09Zcom_10725_2058col_10725_2073
Prophylaxis with Ertapenem in Patients with Obstructive Jaundice Undergoing Endoscopic Retrograde Cholangiopancreatography
Safety, Efficacy, and Biliary Penetration
Sharara, Ala I.
El Hajj, Ihab I.
Mroueh, Mohamad
Kyriacos, Soula Boustani
Abdul-Baki, Heitham
Chaar, Hani F.
Aoun, Elie
Hashash, Jana G.
Mansour, Nabil M.
Kanj, Souha S.
BACKGROUND: Cholangitis and biliary sepsis are rare but serious complications of endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study is to investigate the safety, efficacy, and biliary penetration of ertapenem, a newer carbapenem with a long half-life and broad-spectrum antimicrobial activity, for ERCP prophylaxis. METHODS: Patients with obstructive jaundice without cholangitis received a single dose of ertapenem equal to 1 gram intravenously prior to ERCP. A 2-3 mL bile sample was collected after cannulation and prior to contrast injection. Patients were observed for 72 hours for cholangitis or drug-related adverse events. Biliary ertapenem levels were measured using high-performance liquid chromatography (HPLC).
RESULTS: Twenty-eight patients (ages 18-87 years, M/F ratio 1:1) were enrolled. Seven had no cholestasis and were included to study ertapenem penetration in unobstructed biliary trees. Cannulation was achieved in all patients. One patient (3.6%) with persistent intrahepatic stones developed cholangitis. No drug-related adverse events were noted. The mean time from ertapenem administration to bile collection was 60 ± 24 minutes. There was a significant negative correlation between serum bilirubin and biliary ertapenem levels (r = -0.542, P = 0.003) with the highest level (6.25 μg/mL) noted in unobstructed biliary systems. CONCLUSION: Ertapenem appears to be a safe and effective prophylaxis in patients with obstructive jaundice undergoing ERCP despite a limited biliary penetration in patients with high-grade obstruction.
Published
N/A
2015-12-01T13:09:07Z
2015-12-01T13:09:07Z
2011-03
2015-12-01
Article
0038-4348
http://hdl.handle.net/10725/2749
http://dx.doi.org/10.1097/SMJ.0b013e318205de10
Sharara, A. I., El Hajj, I. I., Mroueh, M., Kyriacos, S. B., Abdul-Baki, H., Chaar, H. F., ... & Kanj, S. S. (2011). Prophylaxis with ertapenem in patients with obstructive jaundice undergoing endoscopic retrograde cholangiopancreatography: safety, efficacy, and biliary penetration. Southern medical journal, 104(3), 189-194.
http://europepmc.org/abstract/med/21297547
en
Southern Medical Journal
oai:laur.lau.edu.lb:10725/28112024-02-01T13:07:06Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Tragopogon porrifolius improves serum lipid profile and increases short-term satiety in rats
Zeeni, Nadine
Daher, Costantine F.
Mroueh, Mohamad
Saab, Lea
Tragopogon porrifolius (white salsify) is an edible plant commonly used in folk medicine in Lebanon and neighbouring countries. This study investigates the effect of the aqueous extract of the aerial part of T. porrifolius on lipemia and appetite regulation using a rat model. Food intake, abdominal fat percentage, blood lipid profile, liver weight and liver enzymes were assessed following 4 weeks of extract intake via drinking water (50, 100, or 250 mg/kg body weight) in standard high-carbohydrate and high-fat dietary conditions. In a separate study, the short term effect of a preload of T. porrifolius extract on food intake was evaluated. Results showed that consumption of the plant extract for a period of four weeks resulted in a marked improvement of the lipid profile (triglycerides, total cholesterol, LDL and HDL cholesterol). Body weight, food intake and intra-abdominal fat were also lower in animals given the plant extract (100 and 250 mg/kg). In addition, T. porrifolius extract preload produced a dose dependent decrease in food intake observed over 24 h. The intake of T. porrifolius aqueous extract therefore improved lipemia and increased satiety in rats with no visible adverse effects.
Published
N/A
2015-12-15T13:29:15Z
2015-12-15T13:29:15Z
2013
2015-12-15
Article
0195-6663
http://hdl.handle.net/10725/2811
http://dx.doi.org/10.1016/j.appet.2013.09.023
Zeeni, N., Daher, C. F., Saab, L., & Mroueh, M. (2014). Tragopogon porrifolius improves serum lipid profile and increases short-term satiety in rats. Appetite, 72, 1-7.
http://www.sciencedirect.com/science/article/pii/S0195666313004054
en
Appetite
oai:laur.lau.edu.lb:10725/28142024-01-31T15:30:39Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Magnetic property, DFT calculation, and biological activity of bis[(μ2-chloro)chloro(1,10-phenanthroline)copper(II)] complex
Mroueh, Mohammad
Daher, Costantine
Hariri, Essa
Demirdjian, Sally
Isber, Samih
Choi, Eun Sang
Mirtamizdoust, Babak
Hammud, Hassan H.
The dinuclear complex bis[(μ2-chloro)chloro(1,10-phenanthroline)copper(II)] (1) was synthesized, and characterized by X-ray, FTIR and thermal analysis. The fitting of magnetic susceptibility and magnetization curve of (1) indicates the occurrence of weak antiferromagnetic exchange interaction between copper(II) ions. The electronic structure has been also determined by density functional theory (DFT) method. Complex (1) displayed potent anticancer activity against B16 (Melanoma), MDA-MB-32 (Breast Adenocarcinoma), A549 (Lung Adenocarcinoma), HT-29 (Colon Adenocarcinoma) and SF (Astrocytoma) cell lines with an average IC50 value of 0.726 μg/ml compared to 4.88 μg/ml for cisplatin. Complex (1) has a better therapeutic index and toxicological profile than cisplatin, and has demonstrated a potential chemotherapeutic property.
Published
N/A
2015-12-16T07:43:29Z
2015-12-16T07:43:29Z
2015
2015-12-16
Article
0009-2797
http://hdl.handle.net/10725/2814
http://dx.doi.org/10.1016/j.cbi.2015.02.023
Mroueh, M., Daher, C., Hariri, E., Demirdjian, S., Isber, S., Choi, E. S., ... & Hammud, H. H. (2015). Magnetic property, DFT calculation, and biological activity of bis [(μ 2-chloro) chloro (1, 10-phenanthroline) copper (II)] complex. Chemico-biological interactions, 231, 53-60.
http://www.sciencedirect.com/science/article/pii/S0009279715000927
en
Chemico-Biological Interactions
oai:laur.lau.edu.lb:10725/28152024-01-31T13:36:15Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Antioxidant and hepatoprotective activities of the oil fractions from wild carrot (Daucus carota ssp. carota)
Shebaby, Wassim N.
Daher, Costantine F.
El-Sibai, Mirvat
Bodman-Smith, Kikki
Mansour, Anthony
Karam, Marc C.
Mroueh, Mohamad
Context: Wild carrot, Daucus carota L. ssp. carota (Apiacae), is widely distributed throughout the world and has various uses in traditional medicine in Lebanon.
Objective: The present study aimed to fractionate and analyze the chemical composition of the Daucus carota oil extract (DCOE) fractions and to evaluate their antioxidant and hepatoprotective properties in vitro and in vivo.
Materials and methods: DCOE was chromatographed on silica gel column to produce four fractions: pentane (F1), 50:50 pentane:diethyl ether (F2), diethyl ether (F3), and 93:7 chloroform: methanol (F4). Qualitative and quantitative analyses of oil fractions were performed by GC-MS and HPLC techniques. The in vitro antioxidant properties were assessed using DPPH, FIC, and ferric-reducing antioxidant power (FRAP) assays. The hepatoprotective property was determined by examining the levels of serum markers (alanine transaminase (ALT) and aspartate transaminase (AST)) and hepatic antioxidant (superoxide dismutase (SOD), catalase (CAT), and glutathione-S-transferase (GST)) enzymes in CCl4-intoxicated mice pretreated with intraperitoenal 50, 100, or 200 mg/kg b.w. of the oil fractions for 5 d.
Results: GCMS analysis of F2 revealed the presence of 2-himachalen-6-ol (61.4%) which is reported for the first time in Daucus carota species. F3 and F4 were rich in phenolics and flavonoids and demonstrated significant DPPH activity (IC50 = 0.29 and 0.38 mg/ml, respectively) and high FRAP values (225.11 and 437.59 µmol FeSO4/g, respectively). The sesquiterpene-rich fraction F1 had the highest FIC ability (IC50 = 0.28 mg/ml). Pretreatment with F1 and F4 reversed the CCl4-induced decrease in SOD, CAT, and GST levels and reduced significantly hepatic damage.
Discussion and conclusion: The current results suggested that wild carrot oil fractions exhibited a unique chemical composition and possessed significant antioxidant activities as well as hepatoprotective effects against CCl4-induced hepatotoxicity.
Published
N/A
2015-12-16T07:52:44Z
2015-12-16T07:52:44Z
2015
2015-12-16
Article
1388-0209
http://hdl.handle.net/10725/2815
http://dx.doi.org/10.3109/13880209.2014.976349
Shebaby, W. N., Daher, C. F., El-Sibai, M., Bodman-Smith, K., Mansour, A., Karam, M. C., & Mroueh, M. (2015). Antioxidant and hepatoprotective activities of the oil fractions from wild carrot (Daucus carota ssp. carota). Pharmaceutical biology, 53(9), 1285-1294.
http://www.tandfonline.com/doi/abs/10.3109/13880209.2014.976349
en
Pharmaceutical Biology
oai:laur.lau.edu.lb:10725/28182024-01-31T15:19:09Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Hepatoprotective, Antioxidant, and Anticancer Effects of the Tragopogon porrifolius Methanolic Extract
Tenkerian, Clara
El-Sibai, Mirvat
Daher, Costantine F.
Mroueh, Mohamad
Tragopogon porrifolius (Asteraceae), commonly referred to as white salsify, is an edible herb used in Lebanese folk medicine to treat cancer and liver dysfunction. In this study, we investigated the antioxidant activity of Tragopogon porrifolius methanolic extract, both in vitro and in vivo, in addition to its hepatoprotective and anticancer activities. Total phenolic and flavonoid contents were measured and found to be mg GAE/g and mg QE/g dry weight, respectively. In vitro antioxidant assays revealed an FRAP value of µmol Fe2+/g of extract and DPPH IC50 value 15.2 µg/mL. In rats subjected to CCl4-induced hepatotoxicity, significant increase in CAT, SOD, and GST levels was detected. The highest dose of the extract (250 mg/kg) recorded a fold increase of 1.68 for SOD, 2.49 for GST, and 3.2 for CAT. The extract also showed substantial decrease in AST (57%), ALT (56%), and LDH (65%) levels. Additionally, the extract caused a dose-dependent decrease in cell viability and proliferation. In conclusion, the methanolic extract of T. porrifolius displayed a relatively high antioxidant activity both in vitro and in vivo as well as hepatoprotective potential against liver toxicity in rats and anticancer effect on MDA-MB-231 and Caco-2 cells.
Published
N/A
2015-12-16T09:23:51Z
2015-12-16T09:23:51Z
2015
2015-12-16
Article
2211-0534
http://hdl.handle.net/10725/2818
http://dx.doi.org/10.1155/2015/161720
Tenkerian, C., El-Sibai, M., Daher, C. F., & Mroueh, M. (2015). Hepatoprotective, Antioxidant, and Anticancer Effects of the Tragopogon porrifolius Methanolic Extract. Evidence-Based Complementary and Alternative Medicine, 2015.
http://www.hindawi.com/journals/ecam/2015/161720/abs/
en
Evidence-Based Complementary and Alternative Medicine
oai:laur.lau.edu.lb:10725/28192024-01-30T13:30:12Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Daucus carota pentane-based fractions arrest the cell cycle and increase apoptosis in MDA-MB-231 breast cancer cells
Shebaby, Wassim N.
Mroueh, Mohammad
Bodman-Smith, Kikki
Mansour, Anthony
Taleb, Robin I.
Daher, Costantine F.
El-Sibai, Mirvat
Background
Daucus carota L.ssp.carota (wild carrot), an herb used in folk medicine worldwide, was recently demonstrated to exhibit anticancer activity. In this study we examined the anticancer effect of Daucus carota oil extract (DCOE) fractions on the human breast adenocarcinoma cell lines MDA-MB-231 and MCF-7 and clarified the mechanism of action.
Methods and results
Using the WST assay, the pentane fraction (F1) and 1:1 pentane:diethyl ether fraction (F2) were shown to possess the highest cytotoxicity against both cell lines. Flow cytometric analysis revealed that both fractions induced the accumulation of cells in the sub-G1 phase, increase in apoptotic cell death and chromatin condensation. The increase in apoptosis in response to treatment was also apparent in the increase in BAX and the decrease in Bcl-2 levels as well as the proteolytic cleavage of both caspase-3 and PARP as revealed by Western blot. Furthermore, treatment of MDA-MB-231 cells with either fraction significantly reduced the level of phosphorylated Erk but did not show any effect on phosphorylated Akt. The combined treatment with a potent PI3K inhibitor (wortmannin) and F1 or F2 fraction had a synergistic inhibitory effect on cell survival which shows that these two drugs work on different pathways.
Conclusions
These results suggest that the pentane-based fractions of DCOE possess potential anti-cancer activity that is mainly mediated through the Erk pathway.
Published
N/A
2015-12-16T09:47:44Z
2015-12-16T09:47:44Z
2014
2016-05-16
Article
1472-6882
http://hdl.handle.net/10725/2819
http://dx.doi.org/10.1186/1472-6882-14-387
Shebaby, W. N., Mroueh, M., Bodman-Smith, K., Mansour, A., Taleb, R. I., Daher, C. F., & El-Sibai, M. (2014). Daucus carota pentane-based fractions arrest the cell cycle and increase apoptosis in MDA-MB-231 breast cancer cells. BMC complementary and alternative medicine, 14, 1-9.
http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-14-387
en
BMC Complementary and Alternative Medicine
oai:laur.lau.edu.lb:10725/28232020-05-07T21:13:25Zcom_10725_2053com_10725_2056com_10725_2058col_10725_2071col_10725_2077col_10725_2073
ALOX5AP gene variants show differential association with coronary artery disease in different populations
Alwan, Ahmad
Youhanna, Sonia C.
Platt, Daniel E.
El-Sibai, Mirvat
Yerezian, Joumana S.
Deeb, Mary E.
Khazen, Georges
Saade, Stephanie
Zreik, Tony G.
El Bayeh, Hamid
Maalouf, Assaad
Zalloua, Pierre A.
Abchee, Antoine
Coronary artery disease (CAD) is a complex disease with various components, genetic as well as environmental. Previous reports correlating ALOX5AP gene variants and CAD showed conflicting results depending on the population studied. In this study, we examined the contribution of ALOX5AP genetic predisposition to CAD in a group of CAD patients and controls carefully selected from the Lebanese population. We genotyped SNPs for ALOX5AP variants in 289 catheterized patients aged ≤52 years with >50% stenosis in at least one main coronary artery and 227 catheterized control subjects aged 60 years and above with 0% stenosis. Chi-square (χ 2) tests and logistic regression showed no significant difference in the allele and genotype frequencies between the CAD or myocardial infarction (MI) cases and the healthy controls. Haplotype analysis using PHASE showed that the distribution of the risk haplotypes among cases and controls were not significantly different and had no attributable risk to CAD (P = 1.00 and P = 0.5, respectively) or MI (P = 0.2 and P = 0.5, respectively). Our data revealed that ALOX5AP gene variants are not predictors of CAD risk or MI risk among Lebanese patients.
Published
N/A
2015-12-17T13:05:01Z
2015-12-17T13:05:01Z
2010
2015-12-17
Article
1868-310X
http://hdl.handle.net/10725/2823
http://dx.doi.org/10.1007/s12687-010-0015-z
Alwan, A., Youhanna, S. C., Platt, D. E., El-Sibai, M., Yerezian, J. S., Deeb, M. E., ... & Maalouf, A. (2010). ALOX5AP gene variants show differential association with coronary artery disease in different populations. Journal of community genetics, 1(3), 107-115.
http://link.springer.com/article/10.1007/s12687-010-0015-z
en
Journal of Community Genetics
oai:laur.lau.edu.lb:10725/28282024-01-31T14:57:42Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Daucus carota Pentane-Based Fractions Suppress Proliferation and Induce Apoptosis in Human Colon Adenocarcinoma HT-29 Cells by Inhibiting the MAPK and PI3K Pathways
Shehaby, Wassim N.
Bodman-Smith, K.B.
Mansour, Anthony
Mroueh, Mohamad
Taleb, Robin I.
El-Sibai, Mirvat
Daher, Costantine F.
Daucus carota L. ssp. carota (Apiacea, wild carrot, Queen Anne's lace) has been used in folk medicine throughout the world and recently was shown to possess anticancer and antioxidant activities. This study aims to determine the anticancer activity of the pentane fraction (F1) and the 1:1 pentane:diethyl ether fraction (F2) of the Daucus Carota oil extract (DCOE) against human colon adenocarcinoma cell lines (HT-29 and Caco-2). Treatment of cells with various concentrations of F1 or F2 fractions produced a dose-dependent inhibition of cell proliferation. Flow cytometric analysis indicated that both fractions induced sub-G1 phase accumulation and increased apoptotic cell death. Western blot revealed the activation of caspase-3, PARP cleavage, and a considerable increase in Bax and p53 levels, and a decrease in Bcl-2 level. Treatment of HT-29 cells with either fraction markedly decreased the levels of both phosphorylated Erk and Akt. Furthermore, the combined treatment of F1 or F2 with wortmannin showed no added inhibition of cell survival suggesting an effect of F1 or F2 through the phosphatidyl inositol 3-kinase (PI3K) pathway. This study proposes that DCOE fractions (F1 and F2) inhibit cell proliferation by inducing cell cycle arrest and apoptosis in HT-29 cells through the suppression of mitogen-activated protein kinase (MAPK)/Erk and PI3K/Akt pathways.
Published
N/A
2015-12-17T13:58:16Z
2015-12-17T13:58:16Z
2015
2015-12-17
Article
1096-620X
http://hdl.handle.net/10725/2828
https://doi.org/10.1089/jmf.2014.3225
Shebaby, W. N., Bodman-Smith, K. B., Mansour, A., Mroueh, M., Taleb, R. I., El-Sibai, M., & Daher, C. F. (2015). Daucus carota pentane-based fractions suppress proliferation and induce apoptosis in human colon adenocarcinoma HT-29 cells by inhibiting the MAPK and PI3K pathways. Journal of Medicinal Food, 18(7), 745-752.
http://online.liebertpub.com/doi/abs/10.1089/jmf.2014.3225
en
Journal of Medical Food
oai:laur.lau.edu.lb:10725/28472020-05-05T11:36:33Zcom_10725_2053com_10725_2058col_10725_2071col_10725_2073
Cancer cell resistance mechanisms
A mini review
Al-Dimassi, S.
Abou-Antoun, T.
El-Sibai, M.
Cancer is a leading cause of death worldwide accounting to 13 % of all deaths. One of the main causes behind the failure of treatment is the development of various therapy resistance mechanisms by the cancer cells leading to the recurrence of the disease. This review sheds a light on some of the mechanisms developed by cancer cells to resist therapy as well as some of the structures involved such as the ABC members’ involvement in chemotherapy resistance and MET and survivin overexpression leading to radiotherapy resistance. Understanding those mechanisms will enable scientists to overcome resistance and possibly improve treatment and disease prognosis
Published
N/A
2015-12-18T07:20:57Z
2015-12-18T07:20:57Z
2014
2015-12-18
Article
1699-048X
http://hdl.handle.net/10725/2847
http://dx.doi.org/10.1007/s12094-014-1162-1
Al-Dimassi, S., Abou-Antoun, T., & El-Sibai, M. (2014). Cancer cell resistance mechanisms: a mini review. Clinical and Translational Oncology, 16(6), 511-516.
http://link.springer.com/article/10.1007%2Fs12094-014-1162-1
en
Clinical and Translational Oncology
oai:laur.lau.edu.lb:10725/33442018-05-22T12:51:57Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
Association of coronary artery disease and chronic kidney disease in Lebanese population
Milane, Aline
Khazen, Georges
Salloum, Angelique K.
Zalloua, Pierre
Ghassibe-Sabbagh, Michella
Zeineddine, Nabil
Masri, Leila
El Bayeh, Hamid
Background: More evidence is emerging on the strong association between chronic kidney disease (CKD) and cardiovascular disease. We assessed the relationship between coronary artery disease (CAD) and renal dysfunction level (RDL) in a group of Lebanese patients. Methods: A total of 1268 patients undergoing cardiac catheterization were sequentially enrolled in a multicenter cross sectional study. Angiograms were reviewed and CAD severity scores (CADSS) were determined. Estimated glomerular filtration rate (eGFR) was calculated and clinical and laboratory data were obtained. CKD was defined as eGFR < 60 ml/min. Logistic regression model was performed using multivariate analysis including all traditional risk factors associated with both diseases. ANOVA and the Tukeytestswere used to compare subgroups of patients and to assess the impact of each disease on the severity of the other. Results: Among the 82% patients who exhibited variable degrees of CAD, 20.6% had an eGFR < 60 ml/min. Logistic regression analysis revealed a bidirectional independent association between CAD and CKD with an OR = 2.01 (P < 0.01) and an OR = 1.99 (P < 0.01) for CAD and CKD frequencies, respectively. We observed a steady increase in the CADSS mean as eGFR declined and a progressive reduction in renal function with the worsening of CAD (P < 0.05). This correlation remained highly significant despite considerable inter-patient variability and was at its highest at the most advanced stages of both diseases. Conclusions: Our results show a strong, independent and graded bidirectional relationship between CAD severity and RDL. We propose to add CAD to the list of risk factors for the development and progression of CKD.
Published
N/A
2016-03-17T07:16:13Z
2016-03-17T07:16:13Z
2015
2016-03-17
Article
1940-5901
http://hdl.handle.net/10725/3344
Milane, A., Khazen, G., Zeineddine, N., Amro, M., Masri, L., Ghassibe-Sabbagh, M., ... & Cazier, J. B. (2015). Association of coronary artery disease and chronic kidney disease in Lebanese population. International journal of clinical and experimental medicine, 8(9), 15866.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658979/
en
International Journal of Clinical and Experimental Medicine
oai:laur.lau.edu.lb:10725/36292024-01-30T09:28:25Zcom_10725_2058com_10725_2053col_10725_2073col_10725_2071
Salvia libanotica improves glycemia and serum lipid profile in rats fed a high fat diet
Bassil, Maya
Daher, Costantine F.
Mroueh, Mohammad
Zeeni, Nadine
Background
Salvia libanotica (S. Libanotica) is a commonly used herb in folk medicine in Lebanon and the Middle East. The present study aimed to assess the scientific basis for the therapeutic use of S. libanotica in glycemia and to evaluate its effects on lipemia and abdominal fat.
Methods
Animals were fed a high-fat diet and allocated into a control and three experimental groups (GI, GII and GIII) receiving incremental doses of the plant water extract in drinking water (50, 150 and 450 mg/Kg body weight respectively) for six weeks.
Results
The intake of S. libanotica extract was associated with a significant decrease in fasting serum glucose (102.9 ± 10.8 in GII and 87.5 ± 6.4 in GIII vs. 152.1 ± 7.9 mg/dl in controls) and a two fold increase in fasting serum insulin (GIII) and liver glycogen content (GII and GIII). Group III also had better glucose tolerance following intraperitoneal glucose challenges. Additionally, the plant extract intake produced a significant improvement in serum HDL (34.4 ± 2.4 in GIII vs. 27.2 ± 1.9 mg/dl in controls) and HDL/LDL cholesterol ratio (2.79 ± 0.32 in GII and 3.02 ± 0.31 in GIII vs. 1.74 ± 0.18 in controls), as well as a decrease in abdominal fat.
Conclusion
The current study is the first to demonstrate that the chronic intake of S. libanotica infusion helps in the prevention of high fat-induced hyperglycemia and dyslipidemia. This supports the plant use as a remedy for the prevention of type 2 diabetes and cardiovascular diseases.
Published
N/A
2016-04-21T12:29:47Z
2016-04-21T12:29:47Z
2015
2016-04-21
Article
1472-6882
http://hdl.handle.net/10725/3629
http://dx.doi.org/ 10.1186/s12906-015-0917-8
Bassil, M., Daher, C. F., Mroueh, M., & Zeeni, N. (2015). Salvia libanotica improves glycemia and serum lipid profile in rats fed a high fat diet. BMC complementary and alternative medicine, 15(1)
http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-015-0917-8
en
BMC Complementary and Alternative Medicine
oai:laur.lau.edu.lb:10725/39202021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Comparison between desferrioxamine and combined therapy with desferrioxamine and deferiprone in iron overloaded thalassaemia patients
Mourad, Fadi H.
Hoffbrand, A. Victor
Sheikh-Taha, Marwan
Koussa, Susane
Khoriaty, Adlette I.
Taher, Ali
Summary. Desferrioxamine (DFX) alone (40–50 mg/kg/d s.c. over 8–12 h, five times weekly) was compared with combined DFX twice weekly and deferiprone (75 mg/kg/d) over 12 months in previously poorly chelated thalassaemia patients. Serum ferritin fell from 5506 ± 635 µg/l (mean ± SEM) to 3998 ± 604 µg/l (P < 0·001; n = 14) in the DFX group and from 4153 ± 517 µg/l to 2805 ± 327 µg/l in the combined group (P < 0·01; n = 11). Deferiprone plus DFX produced a greater mean urine iron excretion (1·01 mg/kg/24 h) than iron intake from blood transfusion in each patient. Main side-effects were skin reactions (DFX alone), nausea and arthralgia (combined therapy). As chelation therapy, the combined protocol was as effective as DFX five times weekly.
Published
N/A
2016-06-01T12:05:15Z
2016-06-01T12:05:15Z
2003
2016-06-01
Article
0007-1048
http://hdl.handle.net/10725/3920
http://dx.doi.org/10.1046/j.1365-2141.2003.04240.x
Mourad, F. H., Hoffbrand, A. V., Sheikh‐Taha, M., Koussa, S., Khoriaty, A. I., & Taher, A. (2003). Comparison between desferrioxamine and combined therapy with desferrioxamine and deferiprone in iron overloaded thalassaemia patients. British journal of haematology, 121(1), 187-189.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2141.2003.04240.x/full
en
British Journal of Haematology
oai:laur.lau.edu.lb:10725/39212021-03-19T10:03:22Zcom_10725_2058col_10725_2073
Comparison between deferoxamine and deferiprone (L1) in iron-loaded thalassemia patients
Taher, A.
Sheikh-Taha, M.
Koussa, S.
Inati, A.
Neeman, R.
Mourad, F.
Abstract: Introduction: Iron-chelating therapy with deferoxamine in patients with thalassemia major has dramatically improved the prognosis of this disease. However, the limitations of this treatment have stimulated the design of alternative orally active iron chelators. Objective: To compare the effectiveness and safety of, and compliance with, oral deferiprone (L1), and deferoxamine, in thalassemia major patients. Methods: All patients were followed up in one center in Lebanon. Sixteen patients were on L1 (75 mg/kg/d), and 40 patients on subcutaneous deferoxamine (20–50 mg/kg/d). Serum ferritin level, urinary iron excretion (UIE) and side effects were monitored over a two year period. Results: Patients on L1 had an initial serum ferritin concentration of 3663±566 µg/l (mean±SEM), that dropped to 2599±314 at 6 months (p<0.02; paired t-test), and stabilised at that level over the 24 months follow up. Patients on deferoxamine had an initial mean serum ferritin concentration of 3480±417 (NS compared to the L1 group), which dropped gradually to 3143±417 (p<0.05) and 2819±292 (p<0.02) at 6 and 24 months, respectively. The most common adverse reactions associated with L1 were arthralgia and nausea, but they did not necessitate stopping the drug. Conclusion: L1 had comparable efficacy as deferoxamine with minimal side effects and better compliance. Provided long term side effects are not encountered, L1 seems to be a valuable alternative iron chelator for patients unable or unwilling to use deferoxamine effectively.
Published
N/A
2016-06-01T12:23:57Z
2016-06-01T12:23:57Z
2001
2016-06-01
Article
0902-4441
http://hdl.handle.net/10725/3921
http://dx.doi.org/10.1034/j.1600-0609.2001.067001030.x
Taher, A., Sheikh‐Taha, M., Koussa, S., Inati, A., Neeman, R., & Mourad, F. (2001). Comparison between deferoxamine and deferiprone (L1) in iron‐loaded thalassemia patients. European journal of haematology, 67(1), 30-34.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1034/j.1600-0609.2001.067001030.x/full
en
European Journal of Haematology
oai:laur.lau.edu.lb:10725/39222021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Safety and Effectiveness of 100 mg/kg/day Deferiprone in Patients with Thalassemia Major
A Two-Year Study
Taher, A.
Sheikh-Taha, M.
Sharara, A.
Inati, A.
Koussa, S.
Dhillon, A.P.
Hoffbrand, A.V.
Deferiprone at a dose of 75 mg/kg/day is not sufficiently effective to maintain iron stores at a level which has been considered safe in all patients with iron overload. Our main aim was to determine the safety of long-term therapy with high-dose (100 mg/kg/day) deferiprone. A secondary aim was to determine the efficacy of this high dose. Twelve thalassemia major patients received deferiprone at a dose of100 mg/kg/day over 2 years. Transient aspartate aminotransferase increase (8 patients), gastrointestinal discomfort (3 patients) and arthralgia (2 patients) were the most commonly reported side effects. None of the patients discontinued therapy. The mean serum ferritin level fell from 3,901 ± 3,618 to 1,790 ± 2,205 µg/l after 2 years (p < 0.05). Five of the 12 patients continued to receive deferiprone for an additional 3 years. No new side effects were encountered. The mean serum ferritin level in this subgroup was initially 2,510 ± 332 µg/l and dropped to 1,511 ± 664 µg/l after 5 years (p < 0.05). Liver iron levels at the end of the 2-year study ranged from 1.0 to 30.9 mg/g dry weight, 3 of the patients having levels above 15 mg/g.
Published
N/A
2016-06-01T12:49:40Z
2016-06-01T12:49:40Z
2005
2016-06-01
Article
0001-5792
http://hdl.handle.net/10725/3922
http://dx.doi.org/10.1159/000087888
Taher, A., Sheikh-Taha, M., Sharara, A., Inati, A., Koussa, S., Ellis, G., ... & Hoffbrand, A. V. (2005). Safety and effectiveness of 100 mg/kg/day deferiprone in patients with thalassemia major: a two-year study. Acta haematologica, 114(3), 146-149.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.karger.com/Article/Abstract/87888
en
Acta Haematologica
oai:laur.lau.edu.lb:10725/39232021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Absence of cardiac siderosis by MRI T2* despite transfusion burden, hepatic and serum iron overload in Lebanese patients with sickle cell disease
Inati, Adlette
Musallam, Khaled M.
Wood, John C.
Sheikh-Taha, Marwan
Daou, Linda
Taher, Ali T.
Background: The use of magnetic resonance imaging (MRI) to detect organ-specific iron overload is becoming increasingly common. Although hepatic iron overload has been recognized in patients with sickle cell disease (SCD), cardiac iron deposition has only been examined in a few reports.
Methods: This was a cross-sectional study of 23 patients with SCD. Patient charts were reviewed and data collected for drug use, total lifetime transfusions (TLT), transfusion rate (TR), status of the spleen, and comorbid illnesses or infections. Blood samples were obtained for assessment of hemoglobin, serum ferritin, non-transferrin-bound iron (NTBI), and liver enzyme levels. Doppler echocardiography was performed to detect pulmonary hypertension (PHT) and assess left ventricular ejection fraction. Cardiac iron levels were measured by MRI T2*. Direct determination of liver iron concentration (LIC) was performed using R2 MRI. In this study, cardiac T2* >20 ms was considered normal.
Results: The mean age was 24.4 ± 9.7 yr, with a male to female ratio of 15:8. A total of 9 (49.9%) patients were splenectomized. The mean TR was 14.1 ± 13.2 Units/yr, and the mean hemoglobin level was 9.0 g/dL. PHT was detected in 6 (27.3%) patients, but none had evidence of heart failure. The mean serum ferritin, LIC, and NTBI levels were 997.7 ng/mL, 4.6 mg Fe/g dw, and 1.1 ± 2.2, respectively. TR was a much better predictor of iron burden (LIC, ferritin, NTBI) than TLT. In fact, TR less than 10 Units/yr did not produce significant iron overload reflecting spontaneous losses as high as 0.11 mg/kg/d. None of the patients had evidence of cardiac iron overload (mean cardiac T2* = 37.3 ± 6.2 ms; range: 21.9–46.8 ms). There was also no statistically significant correlation between cardiac T2* values and any of the study variables.
Conclusion: Our study demonstrates that TR is a stronger predictor of iron overload than TLT. It also confirms cardiac sparing in patients with SCD, even in subjects with significant transfusion burden, systemic and hepatic iron overload.
Published
N/A
2016-06-02T08:00:01Z
2016-06-02T08:00:01Z
2009
2016-06-02
Article
0902-4441
http://hdl.handle.net/10725/3923
http://dx.doi.org/10.1111/j.1600-0609.2009.01345.x
Inati, A., Musallam, K. M., Wood, J. C., Sheikh‐Taha, M., Daou, L., & Taher, A. T. (2009). Absence of cardiac siderosis by MRI T2* despite transfusion burden, hepatic and serum iron overload in Lebanese patients with sickle cell disease. European journal of haematology, 83(6), 565-571.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0609.2009.01345.x/full
en
European Journal of Haematology
oai:laur.lau.edu.lb:10725/39242021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Hydroxyurea Use in Lebanese Patients With [beta]-Thalassemia Intermedia
Taher, Ali
Sheikh-Taha, Marwan
We read with great interest the recent paper by Karimi et al 1 describing the safety and efficacy of hydroxyurea (HU) in reducing complications of extramedullary hemopoiesis as well as increasing Hb levels in Iranian patients with thalassemia intermedia. This prompted us to report our findings on the use of HU in seven Lebanese patients with [beta]-thalassemia intermedia.
Seven patients with [beta]-thalassemia intermedia received oral HU (10-20 mg/kg/d); the mean duration of therapy was 17.4 (range 6-46) months. Complete blood counts, liver enzymes, and serum creatinine levels were evaluated before and during HU. We defined therapy to be effective if there was an increase in Hb of at least 1 g/dL because this was correlated in other studies with symptomatic improvement. Hb rise was evaluated at 6 months and at the end of therapy. Toxicity was divided into hepatic and hematologic. Hematologic toxicity was defined as a decrease in the absolute neutrophil count to below 1.5 × 103/mm3 or a decrease in the platelet count to below 100 × 103. Hepatic toxicity was considered as an increase in liver function tests to least twice the upper normal values.
Patient characteristics and results are summarized in Table 1. Only patients 4 and 7 had an increase in Hb of 1.7 and 3 g/dL, respectively, at 6 months. The rise in Hb was not sustained in patient 4. Patient 5 had an increase in Hb by 1.3 g/dL at month 10, but it decreased back by 0.6 g/dL at month 13. All other patients did not respond to HU. No significant toxicity was reported in our patients.
Graphic Table 1
These findings are in contrast to the findings of Karimi et al. The difference in response to HU between Lebanese and Iranian patients could be due to the heterogenous nature of the disease, resulting from different mutations, and the association between the types of mutations and the response to HU. Other contributing factors may include the differences in the dosages of HU administered, noncompliance with drug therapy, tachyphylaxis to HU effect, the metabolism of the drug, and the small number of patients in our study. Because limited data are available on this subject, more studies in different ethnic groups are required
Published
N/A
2016-06-02T08:16:33Z
2016-06-02T08:16:33Z
2006
2016-06-02
Article
1077-4114
http://hdl.handle.net/10725/3924
10.1097/01.mph.0000200671.39549.2b
Taher, A., & Sheikh-Taha, M. (2006). Hydroxyurea Use in Lebanese Patients With β-Thalassemia Intermedia. Journal of pediatric hematology/oncology, 28(2), 107.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://journals.lww.com/jpho-online/Citation/2006/02000/Hydroxyurea_Use_in_Lebanese_Patients_With.15.aspx
en
Journal of Pediatric Hematology/Oncology
oai:laur.lau.edu.lb:10725/39252021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Possible montelukast-induced angioedema
Sabbagh, Racha
Sheikh-Taha, Marwan
Purpose. A possible case of montelukast-induced angioedema is reported.
Summary. A 46-year-old woman with a history of severe allergies, including food allergies, and angioedema was evaluated at the emergency department (ED) for an acute episode of angioedema. Upon arrival at the ED, the patient had severe jaw tightness, facial numbness, uncontrollable cheek lifting, swollen eyes, and a swollen protruding tongue and was unable to catch her breath. Her dyspnea was apparent, and she was unable to talk and instead used hand and face gestures for affirmative and negative responses. The patient was treated with 0.3 mg epinephrine intramuscularly into the right thigh. After treatment, she had a temperature of 37 °C, a pulse of 90 beats/ min, a blood pressure value of 100/59 mm Hg, a respiratory rate of 16 breaths/min, and 100% oxygen saturation on room air. After stabilization, she reported that her allergies had been adequately controlled with ebastine 10 mg daily, montelukast 10 mg daily, and vitamins (unspecified). The patient reported that since she started montelukast one month prior, she experienced three similar episodes, the first occurring five days after starting the drug. She mentioned being diagnosed and adequately treated these three times in the ED for angioedema. The patient denied any changes in eating habits or in her medications except for starting montelukast. She was observed at the ED for an hour and then discharged after stabilization on hydroxyzine hydrochloride 25 mg orally daily and fexofenadine hydrochloride 180 mg orally daily. Montelukast was discontinued.
Conclusion. A patient developed angioedema four times during one month of treatment with montelukast.
Published
N/A
2016-06-02T08:23:58Z
2016-06-02T08:23:58Z
2009
2016-06-02
Article
1695-0674
http://hdl.handle.net/10725/3925
http://dx.doi.org/10.2146/ajhp080408
Sabbagh, R., & Sheikh-Taha, M. (2009). Possible montelukast-induced angioedema. American Journal of Health-System Pharmacy, 66(19), 1705-1706.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=0&sid=c00270ab-a03f-4a2b-9d19-9a976592e3fc%40pdc-v-sessmgr06
en
American Journal of Health-System Pharmacy
oai:laur.lau.edu.lb:10725/39262021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Febrile Neutropenia and Hemorrhagic Stroke in a Thalassemia Major Patient
Sheikh-Taha, Marwan
Koussa, Suzanne
Inati, Adlette
Taher, Ali
A 36-year-old transfusion-dependent thalassemia major patient presented with febrile neutropenia and anemia. Deferiprone (L1) was discontinued as it was suspected to be the offending agent and prompt broad-spectrum antibiotic therapy was initiated after which the patient improved. After 11 days the patient developed hemorrhagic stroke and seizure whereby aspirin was discontinued and supportive therapy was given.
Agranulocytosis is the most serious complication reported with L1 but, to the best of our knowledge, there are no previous reports on hemorrhagic stroke associated with the use of the agent, and hence, the etiology of the stroke which followed agranulocytosis caused by L1 remains obscure.
Published
N/A
2016-06-02T08:41:23Z
2016-06-02T08:41:23Z
2007
2016-06-02
Article
0363-0269
http://hdl.handle.net/10725/3926
http://dx.doi.org/10.1080/03630260701641211
Sheikh-Taha, M., Koussa, S., Inati, A., & Taher, A. (2007). Febrile neutropenia and hemorrhagic stroke in a thalassemia major patient. Hemoglobin, 31(4), 499-501.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.tandfonline.com/doi/abs/10.1080/03630260701641211
en
Hemoglobin
oai:laur.lau.edu.lb:10725/39272021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Effect of Intermittent Nesiritide Administration on Kidney Function
Sheikh-Taha, Marwan
Zeitoun, Abeer
Published
N/A
2016-06-02T08:47:14Z
2016-06-02T08:47:14Z
2012
2016-06-02
Article
1074-2484
http://hdl.handle.net/10725/3927
Sheikh-Taha, M., & Zeitoun, A. (2012). Effect of Intermittent Nesiritide Administration on Kidney Function. Journal of cardiovascular pharmacology and therapeutics, 17(2), 229-230.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://cpt.sagepub.com/content/17/2/229.short
en
Journal of Cardiovascular Pharmacology and Therapeutics
oai:laur.lau.edu.lb:10725/39282021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Subarachnoid hemorrhage associated with tadalafil
Sheikh-Taha, Marwan
Tadalafil is a phosphodiesterase type-5 (PDE5) inhibitor indicated for the treatment of erectile dysfunction. Inhibition of the PDE5 isoenzyme, which is responsible for degradation of cyclic guanosine monophosphate in the corpus cavernosum, will ultimately enhance the effect of nitric oxide and, consequently, the relaxation of the vascular smooth muscle in the corpus cavernosum and penile erection after sexual stimulation. Tadalafil is the longest-acting PDE5 inhibitor, with an elimination half-life of 17.5 hours and up to 36 hours’ duration of effect. The drug has been associated with headache, flushing, dizziness, visual disturbances, and hypotension.1
A 45-year-old previously healthy man arrived at the emergency department with a severe headache of five hours’ duration associated with one episode of vomiting. There was no decrease in the level of consciousness, no focal neurologic deficit, and no convulsive activity. The patient was...
Published
N/A
2016-06-02T08:56:45Z
2016-06-02T08:56:45Z
2011
2016-06-02
Article
1079-2082
http://hdl.handle.net/10725/3928
http://dx.doi.org/10.2146/ajhp100506
Sheikh-Taha, M., & Alaywa, R. A. (2011). Subarachnoid hemorrhage associated with tadalafil. American Journal of Health-System Pharmacy, 68(13), 1195-1196.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://ku7rj9xt8c.scholar.serialssolutions.com/?sid=google&auinit=M&aulast=Sheikh-Taha&atitle=Subarachnoid+hemorrhage+associated+with+tadalafil.&id=pmid:21690423
en
American Journal of Health-System Pharmacy
oai:laur.lau.edu.lb:10725/39292021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Use of deep vein thrombosis prophylaxis in hospitalized cancer patients
Awar, Zeina
Sheikh-Taha, Marwan
Venous thromboembolism is a common complication and a major cause of morbidity and mortality in cancer patients. Patients with malignancies have a four-fold greater risk of venous thromboembolism compared with patients without malignancies. Underuse of deep vein thrombosis (DVT) prophylaxis persists, despite guidelines supporting its use in hospitalized cancer patients. This study was conducted to evaluate the use of DVT prophylaxis and its appropriateness in hospitalized cancer patients. This retrospective study included cancer patients admitted to Rafik Hariri University Hospital, a tertiary referral center in Beirut, Lebanon, over 2-month period, who were hospitalized for at least 2 days. We evaluated the use of anticoagulants for DVT prophylaxis in the absence of contraindications for their use. The risk factor profiles of the patients were reported in addition to the choice of the anticoagulant and the use of mechanical prophylaxis in patients with contraindications to anticoagulation. One hundred and thirty patients were studied out of which 34 (26.2%) had contraindications to anticoagulation use. In addition, 21 patients out of 95 (22.1%) who qualified for DVT prophylaxis received pharmacologic DVT prophylaxis. Enoxaparin was the most frequently prescribed anticoagulant (76.2% of the patients). Of those who received anticoagulation, only 47.6% received appropriate agent and dose. Among patients with contraindications to anticoagulation, only three (8.8%) received mechanical devices as nonpharmacologic DVT prophylaxis. DVT prophylaxis in hospitalized cancer patients is significantly underutilized. Several options are available to increase physicians' awareness of the problem.
Published
N/A
2016-06-02T09:08:35Z
2016-06-02T09:08:35Z
2009
2016-06-02
Article
0957-5235
http://hdl.handle.net/10725/3929
http://dx.doi.org/10.1097/MBC.0b013e32832fa7df
Awar, Z., & Sheikh-Taha, M. (2009). Use of deep vein thrombosis prophylaxis in hospitalized cancer patients. Blood Coagulation & Fibrinolysis, 20(7), 571-574.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://journals.lww.com/bloodcoagulation/Abstract/2009/10000/Use_of_deep_vein_thrombosis_prophylaxis_in.14.aspx
en
Blood Coagulation & Fibrinolysis
oai:laur.lau.edu.lb:10725/39302021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Oral aphthous ulcers associated with orlistat
Sheikh-Taha, Marwan
Orlistat, a reversible inhibitor of gastrointestinal lipase, is indicated for obesity management including weight loss and weight maintenance when used in conjunction with a reduced-calorie diet. It is also indicated to reduce the risk of weight gain after prior weight loss. At the recommended dosage of 120 mg three times daily, orlistat inhibits dietary fat absorption by approximately 30%. The drug should be given with meals or up to one hour after each meal.1
The most common adverse effects reported in patients receiving orlistat are gastrointestinal symptoms, including abdominal discomfort, oily spotting, flatus, fecal urgency, fatty or oily stools, increased defecation, and fecal incontinence. Rare but serious adverse effects include liver failure and oxalate nephropathy.1,2 We report two cases of oral aphthous ulcers associated with the use of orlistat.
In the first...
Published
N/A
2016-06-02T09:15:26Z
2016-06-02T09:15:26Z
1079-2082
2016-06-02
Article
1079-2082
http://hdl.handle.net/10725/3930
http://dx.doi.org/10.2146/ajhp120073
Sheikh-Taha, M., Ghosn, S., & Zeitoun, A. (2012). Oral aphthous ulcers associated with orlistat. American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists, 69(17), 1462-1464.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://academic.oup.com/ajhp/article-abstract/69/17/1462/5112009
en
American Journal of Health-System Pharmacy
oai:laur.lau.edu.lb:10725/39312021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Comparison of Bolus Only With Bolus Plus Infusion of Bivalirudin in Patients Undergoing Elective Percutaneous Coronary Intervention
A Retrospective Observational Study
Sheikh-Taha, Marwan
Ghosn, Samer
Background: Anticoagulation therapy during percutaneous coronary intervention (PCI) has been the focus of numerous clinical trials. Low-anticoagulant doses have been successfully used in patients undergoing elective PCI, a situation with low-thrombogenic milieu. Objective: The purpose of the study was to evaluate the safety and efficacy of shorter duration of treatment with bivalirudin in patients undergoing elective PCI and receiving optimal antiplatelet therapy. Methods: We compared patients undergoing PCI who received aspirin and clopidogrel loading dose in addition to either conventional bivalirudin dosing (intravenous [IV] bolus of 0.75 + 1.75 mg/kg per h for the duration of PCI; n = 197) or a reduced bivalirudin dose (IV bolus of 0.75 mg/kg; n = 200). Results: Procedural success was obtained in 100% of cases. The primary end point (in-hospital death, acute myocardial infarction, or need for urgent target vessel revascularization) did not differ between both the groups (6 patients [3%] in the conventional dose group vs 5 patients [2.5%] in the reduced dose group). Major bleeding occurred in 1 patient in the conventional dose group (P = nonsignificant [NS]). Minor bleeding occurred in 4 patients (2%) in the conventional dose group vs 5 patients (2.5%) in the reduced dose group (P = NS) and was mainly due to bleeding at entry site. Conclusion: In patients undergoing elective PCI, using bivalirudin as a bolus only dosing may be as effective and less costly when compared with bolus followed by an infusion for the duration of the intervention. A larger study is needed to confirm our findings.
Published
N/A
2016-06-02T09:30:19Z
2016-06-02T09:30:19Z
2012
2016-06-02
Article
0897-1900
http://hdl.handle.net/10725/3931
http://dx.doi.org/10.1177/0897190012442721
Sheikh-Taha, M., & Ghosn, S. (2012). Comparison of Bolus Only With Bolus Plus Infusion of Bivalirudin in Patients Undergoing Elective Percutaneous Coronary Intervention: A Retrospective Observational Study. Journal of pharmacy practice, 25(5), 537-540.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://jpp.sagepub.com/content/25/5/537.full.pdf+html
en
Journal of Pharmacy Practice
oai:laur.lau.edu.lb:10725/39322021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Intermittent nesiritide therapy in outpatients with chronic heart failure
Sheikh-Taha, Marwan
Heart failure (HF) continues to be a significant health problem in the United States. Nearly 550,000 people are diagnosed annually with this condition, and HF is responsible for over 1 million hospitalizations per year.1,2 Despite advances in pharmacologic therapy, a small percentage of patients with severe HF remain refractory to maximum medical therapy. In addition, these patients have high mortality rates, a poor quality of life, and frequent hospitalizations with elevated health care costs. For this subset of patients, some centers in the United States continue to use periodic ino-tropic therapy on an inpatient or outpatient basis under the rationale of reducing symptoms, hospitalizations, and medical costs, even at the risk of increased mortality.
Nesiritide, a human B-type natriuretic peptide, is the first of a new class of agents for the treatment of decompensated HF. In...
Published
N/A
2016-06-02T11:05:33Z
2016-06-02T11:05:33Z
2005
2016-06-02
Article
1079-2082
http://hdl.handle.net/10725/3932
https://doi.org/10.1093/ajhp/62.2.196
Sheikh-Taha, M. (2005). Intermittent nesiritide therapy in outpatients with chronic heart failure. American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists, 62(2), 196-198.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://academic.oup.com/ajhp/article-abstract/62/2/196/5135612
en
American Journal of Health-System Pharmacy
oai:laur.lau.edu.lb:10725/39342021-03-19T10:00:54Zcom_10725_2058col_10725_2073
Effect of age and sex on warfarin dosing
Khoury, Ghada
Sheikh-Taha, Marwan
Objective
We examined the potential effect of sex and age on warfarin dosing in ambulatory adult patients.
Methods
We conducted a retrospective chart review of patients attending an anticoagulation clinic. We included patients anticoagulated with warfarin for atrial fibrillation or venous thromboembolism who had a therapeutic international normalized ratio of 2–3 for 2 consecutive months. We excluded patients who had been on any drug that is known to have a major interaction with warfarin, smokers, and heavy alcohol consumers. Out of 340 screened medical records, 96 met the predetermined inclusion criteria. The primary outcome assessed was warfarin total weekly dose (TWD).
Results
There was a statistically significant difference in the TWD among the ages (P<0.01); older patients required lower doses. However there was no statistically significant difference in the TWD between sexes (P=0.281).
Conclusion
Age was found to have a significant effect on warfarin dosing. Even though women did require a lower TWD than men, this observation was not statistically significant.
Published
N/A
2016-06-02T12:03:50Z
2016-06-02T12:03:50Z
2014
2016-06-02
Article
1179-1438
http://hdl.handle.net/10725/3934
http://dx.doi.org/10.2147/CPAA.S66776
Khoury, G., & Sheikh-Taha, M. (2014). Effect of age and sex on warfarin dosing. Clinical pharmacology: advances and applications, 6, 103.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103915/
en
Clinical Pharmacology: Advances and Applications
oai:laur.lau.edu.lb:10725/39352021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Autoimmune Hemolytic Anemia Induced by Levofloxacin
Sheikh-Taha, Marwan
Frenn, Pascale
Drug-induced autoimmune hemolytic anemia is a rare condition. We report the case of a 32-year-old white female who presented to the emergency department with generalized fatigue, fever, and jaundice. The patient reported using levofloxacin few days prior to presentation for urinary tract infection. The patient had evidence of hemolytic anemia with a hemoglobin of 6.7 g/dL which dropped to 5 g/dL on day 2, the direct Coombs test was positive, indirect bilirubin was 5.5 mg/dL, and LDH was 1283 IU/L. Further testing ruled out autoimmune disease, lymphoma, and leukemia as etiologies for the patient’s hemolytic anemia. Levofloxacin was immediately stopped with a gradual hematologic recovery within few days
Published
N/A
2016-06-02T12:27:16Z
2016-06-02T12:27:16Z
2014
2016-06-02
Article
2090-6625
http://hdl.handle.net/10725/3935
http://dx.doi.org/10.1155/2014/201015
Sheikh-Taha, M., & Frenn, P. (2014). Autoimmune Hemolytic Anemia Induced by Levofloxacin. Case reports in infectious diseases, 2014.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.hindawi.com/journals/criid/2014/201015/abs/
en
Case Reports in Infectious Diseases
oai:laur.lau.edu.lb:10725/39362021-03-19T10:00:49Zcom_10725_2058col_10725_2073
Use of acid suppressive therapy in hospitalized non-critically
ill patients
Sheikh-Taha, Marwan
Alaeddine, Sarah
Nassif, Julie
AIM: To assess the appropriateness of prescribing acid suppressive therapy (AST) in a general medicine service in a tertiary care hospital.
METHODS: In this retrospective observational study, we reviewed the inpatient records of all patients admitted to the general medical service in a tertiary care hospital in Beirut, Lebanon, from April 1 to May 31, 2011. Treatment with AST was considered appropriate if the patient had a specific indication or appropriate treatment purpose [e.g., gastro-esophageal reflux disease (GERD), peptic ulcer disease, dyspepsia, acute or suspected gastrointestinal (GI) bleeding]. Appropriate administration of stress ulcer prophylaxis (SUP) was derived from an internal guideline that is based on the American Society of Health System Pharmacists guidelines. Prophylaxis was considered appropriate if a patient had 1 absolute indication (coagulopathy or requiring mechanical ventilation), or 2 or more relative indications (sepsis, occult bleeding, use of high dose corticosteroids, recent use of non-steroidal anti-inflammatory drugs for more than 3 mo, renal or liver failure, enteral feeding and anticoagulant use).
RESULTS: Of the 153 patient admissions during the study period, 130 patients (85%) were started on AST, out of which 11 (8.5%) had a diagnosis that supports the use of this therapy (GI bleed, gastritis and GERD), 16 (12.3%) had an absolute indication for SUP, 59 (45.4%) had 2 or more relative indications for SUP, and 44 (33.8%) received AST without an appropriate indication. In addition, one patient with an absolute indication for SUP and four with two or more relative indications did not receive AST. Rabeprazole was the most frequently used AST (59.2%), followed by omeprazole (24.6%), esomeprazole (11.6%) and ranitidine (4.6%). The dose of AST was appropriate in 126 patients (96.9%) and the route of administration was appropriate in 123 patients (94.6%). Fifteen of the admitted patients (10%) were discharged on AST, 7 of which (47%) did not have an appropriate indication.
CONCLUSION: AST is overused in hospitalized non-critically ill patients and many patients are discharged on unnecessary AST which can increase cost, drug interactions and adverse events. Potential interventions include implementation of institutional protocols and prescriber education
Published
N/A
2016-06-02T12:40:25Z
2016-06-02T12:40:25Z
2012
2016-06-02
Article
2150-5349
http://hdl.handle.net/10725/3936
http://dx.doi.org/10.4292/wjgpt.v3.i6.93
Sheikh-Taha, M., Alaeddine, S., & Nassif, J. (2012). Use of acid suppressive therapy in hospitalized non-critically ill patients. World Journal of Gastrointestinal Pharmacology and Therapeutics, 3(6), 93.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596518/
en
World Journal of Gastrointestinal Pharmacology and Therapeutics
oai:laur.lau.edu.lb:10725/39372021-03-19T10:00:50Zcom_10725_2058col_10725_2073
Diagnostic considerations for Novel Influenza A (H1N1)
Sheikh-Taha, Marwan
Eiland III, Edward H.
Han, Jian
Lindgren, Willliam
Macandrew, Thomas
English, Ali Hassoun
Background: The emergence of novel swine-origin influenza A (H1N1) virus (S-OIV) infection represents a significant pandemic threat. Rapid and accurate diagnosis will enhance treatment and containment efforts.
Methods: Ninety eight patients with influenza-like illness meeting the CDC’s guidelines for screening were tested with the rapid influenza test.
Positive samples for influenza A were tested with real-time PCR (RT-PCR). Subsequently, all samples were tested using Target Enriched Multiplex
Polymerase Chain Reaction (Tem-PCR).
Results: Rapid influenza tests
Conclusion: Clinical judgment should be applied when interpreting the results of the available S-OIV tests. A confirmatory and validated test for SOIV
is urgently needed.
confirmed 30 influenza A cases, 1 of influenza B, and resulted 67 negatives. The 30 samples positive for influenza A
were tested using RT-PCR assay, which revealed 2 cases of seasonal influenza A, 7 cases of S-OIV, and 21 negatives for influenza infection. The TemPCR
confirmed 1 of the seasonal influenza A cases but found the second case to be S-OIV. Tem-PCR confirmed the findings of RT-PCR in 3 of the SOIV
cases but reported 4 of the cases negative for influenza. Additionally, Tem-PCR found 3 of the cases that were negative per RT-PCR were
positive for S-OIV. The remainders were confirmed negative for influenza yet one was positive for adenovirus. The lone case of influenza B was
confirmed with Tem-PCR. Among the 67 cases that were negative based on rapid influenza tests, Tem-PCR confirmed
Published
N/A
2016-06-02T13:08:34Z
2016-06-02T13:08:34Z
2012
2016-06-02
Article
Sheikh-Taha, M., Eiland E, Han J., Lindgren w., Macandrew English T., Hassoun A. (2012). Diagnostic considerations for novel influenza A (H1N1): International journal of pharmacy and pharmaceutical sciences,4 Suppl.1,73-75
0975-1491
http://hdl.handle.net/10725/3937
Sheikh-Taha, M., Eiland III, E. H., Han, J., Lindgren, W., Macandrew, T., & English, A. H. (2012). Diagnostic considerations for novel influenza A (H1N1). International journal of pharmacy and pharmaceutical sciences, 4 (Suppl.1), 73-75.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.ijppsjournal.com/Vol4Suppl1/2931.pdf
en
International Journal of Pharmacy and Pharmaceutical Sciences
oai:laur.lau.edu.lb:10725/39382021-03-19T10:03:20Zcom_10725_2058col_10725_2073
Safety and efficacy of six-month outpatient intermittent nesiritide infusions
Sheikh-Taha, Marwan
Published
N/A
2016-06-03T05:58:36Z
2016-06-03T05:58:36Z
2011
2016-06-03
Article
0975-1491
http://hdl.handle.net/10725/3938
Sheikh‐Taha, M. (2011). Safety and efficacy of six‐month outpatient intermittent nesiritide infusions. International Journal of Pharmacy and Pharmaceutical Sciences , 3 Suppl. 5, 177-179.
http://libraries.lau.edu.lb/research/laur/terms-of-use/thesis.php
https://innovareacademics.in/journal/ijpps/Vol3Suppl5/2752.pdf
en
International Journal of Pharmacy and Pharmaceutical Sciences
oai:laur.lau.edu.lb:10725/41592021-03-19T10:03:23Zcom_10725_2058col_10725_2073
Peptidase Activity of the Escherichia coli Hsp31 Chaperone
Malki, Abderrahim
Caldas, Therese
Abdallah, Jad
Kern, Renee
Eckey, Viola
Kim, So Jung
Cha, Sun-Shin
Mori, Hirotada
Richard, Richarme
Hsp31, the Escherichia coli hcha gene product, is a molecular chaperone whose activity is inhibited by ATP at high temperature. Its crystal structure reveals a putative Cys184, His185, and Asp213 catalytic triad similar to that of the Pyrococcus horikoshii protease PH1704, suggesting that it should display a proteolytic activity. A preliminary report has shown that Hsp31 has an exceedingly weak proteolytic activity toward bovine serum albumin and a peptidase activity toward two peptide substrates with small amino acids at their N terminus (alanine or glycine), but the physiological significance of this observation remains unclear. In this study, we report that Hsp31 does not diplay any significant proteolytic activity but has peptidolytic activity. The aminopeptidase cleavage preference of Hsp31 is Ala > Lys > Arg > His, suggesting that Hsp31 is an aminopeptidase of broad specificity. Its aminopeptidase activity is inhibited by the thiol reagent iodoacetamide and is completely abolished in a C185A mutant, which is consistent with Hsp31 being a cysteine peptidase. The aminopeptidase activity of Hsp31 is also inhibited by EDTA and 1,10-phenanthroline, in concordance with the importance of the putative His85, His122, and Glu90 metal-binding site revealed by crystallographic studies. An Hsp31-deficient mutant accumulates more 8–12-mer peptides than its parental strain, and purified Hsp31 can transform these peptides into smaller peptides, suggesting that Hsp31 has an important peptidase function both in vivo and in vitro. Proteins interacting with Hsp31 have been identified by reverse purification of a crude E. coli extract on an Hsp31-affinity column, followed by SDS-polyacrylamide electrophoresis and mass spectrometry. The ClpA component of the ClpAP protease, the chaperone GroEL, elongation factor EF-Tu, and tryptophanase were all found to interact with Hsp31, thus substantiating the role of Hsp31 as both chaperone and peptidase.
Published
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2016-07-19T06:20:30Z
2016-07-19T06:20:30Z
2004
2016-07-19
Article
0021-9258
http://hdl.handle.net/10725/4159
http://dx.doi.org/10.1074/jbc.M408296200
Malki, A., Caldas, T., Abdallah, J., Kern, R., Eckey, V., Kim, S. J., ... & Richarme, G. (2005). Peptidase activity of the Escherichia coli Hsp31 chaperone. Journal of Biological Chemistry, 280(15), 14420-14426.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.jbc.org/content/280/15/14420.short
en
The Journal of Biological Chemistry
oai:laur.lau.edu.lb:10725/41602021-03-19T09:59:51Zcom_10725_2058col_10725_2073
Escherichia coli HdeB Is an Acid Stress Chaperone
Kern, Renee
Malki, Abderrahim
Abdallah, Jad
Tagourti, Jihen
Richarme, Gilbert
We cloned, expressed, and purified the hdeB gene product, which belongs to the hdeAB acid stress operon.
We extracted HdeB from bacteria by the osmotic-shock procedure and purified it to homogeneity by ionexchange
chromatography and hydroxyapatite chromatography. Its identity was confirmed by mass spectrometry
analysis. HdeB has a molecular mass of 10 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis,
which matches its expected molecular mass. We purified the acid stress chaperone HdeA in parallel
in order to compare the two chaperones. The hdeA and hdeB mutants both display reduced viability upon acid
stress, and only the HdeA/HdeB expression plasmid can restore their viability to close to the wild-type level,
suggesting that both proteins are required for optimal protection of the bacterial periplasm against acid stress.
Periplasmic extracts from both mutants aggregate at acidic pH, suggesting that HdeA and HdeB are required
for protein solubilization. At pH 2, the aggregation of periplasmic extracts is prevented by the addition of
HdeA, as previously reported, but is only slightly reduced by HdeB. At pH 3, however, HdeB is more efficient
than HdeA in preventing periplasmic-protein aggregation. The solubilization of several model substrate
proteins at acidic pH supports the hypothesis that, in vitro, HdeA plays a major role in protein solubilization
at pH 2 and that both proteins are involved in protein solubilization at pH 3. Like HdeA, HdeB exposes
hydrophobic surfaces at acidic pH, in accordance with the appearance of its chaperone properties at acidic pH.
HdeB, like HdeA, dissociates from dimers at neutral pH into monomers at acidic pHs, but its dissociation is
complete at pH 3 whereas that of HdeA is complete at a more acidic pH. Thus, we can conclude that Escherichia
coli possesses two acid stress chaperones that prevent periplasmic-protein aggregation at acidic pH.
Published
N/A
2016-07-19T06:36:25Z
2016-07-19T06:36:25Z
2006
2016-07-19
Article
0021-9193
http://hdl.handle.net/10725/4160
http://dx.doi.org/10.1128/JB.01522-06
Kern, R., Malki, A., Abdallah, J., Tagourti, J., & Richarme, G. (2007). Escherichia coli HdeB is an acid stress chaperone. Journal of bacteriology, 189(2), 603-610.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://jb.asm.org/content/189/2/603.full.pdf+html
en
Journal of Bacteriology
oai:laur.lau.edu.lb:10725/41612021-03-19T09:59:51Zcom_10725_2058col_10725_2073
Characterization of the Escherichia coli YedU protein as a molecular chaperone
Malki, Abderrahim
Kern, Renee
Abdallah, Jad
Richarme, Gilbert
We have cloned, purified to homogeneity, and characterized as a molecular chaperone the Escherichia coli YedU protein. The purified protein shows a single band at 31 kDa on SDS–polyacrylamide gels and forms dimers in solution. Like other chaperones, YedU interacts with unfolded and denatured proteins. It promotes the functional folding of citrate synthase and α-glucosidase after urea denaturation and prevents the aggregation of citrate synthase under heat shock conditions. YedU forms complexes with the permanently unfolded protein, reduced carboxymethyl α-lactalbumin. In contrast to DnaK/Hsp70, ATP does not stimulate YedU-dependent citrate synthase renaturation and does not affect the interaction between YedU and unfolded proteins, and YedU does not display any peptide-stimulated ATPase activity. We conclude that YedU is a novel chaperone which functions independently of an ATP/ADP cycle.
Every organism responds to a sudden increase in the environmental temperature by the overexpression of a set of highly conserved heat shock proteins [1]. Most of these heat shock proteins function either as molecular chaperones, assisting in protein folding and renaturation or as proteases degrading proteins that are beyond help. The explosion of genome sequencing has revealed a number of conserved genes without assigned functions (more than 30% of the Escherichia coli ORFs have no known function) [2]. We are trying to discover new functions that would help to understand the role of the heat shock response in the cell. A recent screen of the 4290 ORFs in E. coli by DNA array technology revealed 77 ORFs that are induced more than 5-fold at the RNA level upon temperature upshift [2]. The function of more than 25 of these proteins is unknown. We recently cloned and characterized the heat shock protein FtsJ (renamed RrmJ) as the 23S RNA Um2552 methyltransferase [3]. In the present study, we describe the cloning and purification of the YedU heat shock protein and show that it acts as a molecular chaperone in vitro.
Molecular chaperones are implicated in protein folding, protein targeting to membranes, protein renaturation or degradation after stress, and the control of protein–protein interactions. They can distinguish native proteins from their non-native forms, owing to the specificity of their peptide binding site, and they catalyze protein folding and renaturation in vitro (reviewed in [4] and [5]). The major classes of bacterial chaperones comprise DnaK/Hsp70 (and its assistants DnaJ and GrpE), GroEL/Hsp60 (and its assistant GroES), HtpG/Hsp90, and the small heat shock proteins [4] and [5]. In this study, we show that YedU increases the refolding of unfolded proteins, protects proteins against thermal denaturation, and forms stable complexes with the permanently unfolded protein R-CMLA.
Published
N/A
2016-07-19T08:19:52Z
2016-07-19T08:19:52Z
2003
2016-07-19
Article
0006-291X
http://hdl.handle.net/10725/4161
http://dx.doi.org/10.1016/S0006-291X(02)03053-X
Malki, A., Kern, R., Abdallah, J., & Richarme, G. (2003). Characterization of the Escherichia coli YedU protein as a molecular chaperone. Biochemical and biophysical research communications, 301(2), 430-436.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.sciencedirect.com/science/article/pii/S0006291X0203053X
en
Biochemical and Biophysical Research Communications
oai_dc///com_10725_2058/100