Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case-control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged ≥ 40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking (waterpipe and cigarette) and nicotine dependence. ANOVA, Student, Kruskal-Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking (OR = 6.4), previous mixed smoking (OR = 38.03) and current mixed smoking (OR = 7.68) were significantly associated with chronic bronchitis (P < 0.001 for all) but current exclusive waterpipe smoking was not (OR = 1.87, 95% CI: 0.74-4.72). Current waterpipe dependence was significantly associated with chronic bronchitis (OR = 3.74, P < 0.001). After adjustment for covariates/confounders, ever waterpipe smoking > 20 WP-years (P < 0.001) was significantly associated with chronic bronchitis. . Une dépendance au narguilé au moment de l'étude était significativement associée à une bronchite chronique (OR = 3,74 ; P<0,001). Après ajustements pour des co-variables/des facteurs de confusion, une consommation supérieure à 20 narguilés-an à un moment donné dans le passé (P<0,001) était significativement associée à une bronchite chronique.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫العارش‬ ‫العدد‬ 997

Background In the year 2020, the coronavirus pandemic invaded the world. Since then, specialized companies began to compete, producing many vaccines. Coronavirus vaccines have different adverse events. Menstrual disorders have been noticed as a common complaint post-vaccination. Aim Our study fills an important gap by evaluating the relationship between coronavirus vaccines and menstrual disorders. Methods This is a cross-sectional study between 20 September 2021, and 1 October 2021, using an online survey. The questionnaire consisted of 36 questions divided into 4 sections: demographics, COVID-19 exposure and vaccination, hormonal background, and details about the menstrual cycle. Sample t -test, ANOVA test, chi-square, and McNemar test were used in bivariate analysis. Results This study includes 505 Lebanese adult women vaccinated against COVID-19. After vaccination, the number of women having heavy bleeding or light bleeding increased ( p = 0.02 and p < 0.001, respectively). The number of women having regular cycles decreased after taking the vaccine ( p < 0.001). Irregularity in the cycle post-vaccination was associated with worse PMS symptoms ( p = 0.036). Women using hormonal contraception method or using any hormonal therapy had higher menstrual irregularity rates ( p = 0.002 and p = 0.043, respectively). Concerning vaccine adverse events, those who had headaches had a higher rate of irregularity ( p = 0.041). Those having PCOS, osteoporosis, or blood coagulation disorders had higher irregularity rate ( p < 0.001 and p = 0.005, respectively). Conclusion Vaccine adverse events may include specific menstrual irregularities. Moreover, some hormonal medications and diseases are associated with the alteration of the menstrual cycle. This study helps in predicting vaccines’ menstrual adverse events, especially in a specific population prone to menstrual disorders.

Background Medication waste is a public health problem affecting developed and developing countries. In Lebanon, a developing country in the Middle East, efforts are being deployed in hospitals but not in the community. Objective This study aimed to validate a questionnaire to explore the knowledge, attitude, and practice (KAP) towards the disposal of unused and expired medicines among the Lebanese population and then identify the factors associated with these variables comparatively between the general population and healthcare professionals. Methods A cross-sectional study was conducted among the general Lebanese population in May–June 2022 using a standardized questionnaire. The validity and reliability of the KAP scales were assessed, then a thorough statistical analysis was done to explore the factors associated with these scales. Results The KAP scales generated by this study were valid and reliable. Using these scales, 24.5%, 22.6%, and 21% of participants demonstrated proper knowledge, attitude, and practice, respectively. Higher knowledge scores were significantly associated with female gender (Beta = 0.97), a high monthly income (Beta = 1.68), a secondary (Beta = 6.11) or university (Beta = 6.80) education level, and postgraduate education (Beta = 7.13). However, older age (Beta = − 0.06) and a low monthly income (Beta = − 3.06) were significantly associated with lower knowledge scores. A higher knowledge score (Beta = 0.06) was significantly associated with a more positive attitude regarding unused or expired medication disposal. Being a healthcare professional (Beta = 0.72) was significantly associated with a higher practice score, while being a female (Beta = − 0.32) and living in a rural area (Beta = − 0.37) were significantly associated with lower practice scores. Conclusion This study validated KAP scales regarding medication waste in Lebanon and showed low KAP scores in the majority of respondents. Factors associated with higher KAP scores in various aspects of medication disposal, including gender, age, education level, and profession (healthcare professionals), suggest the need to consider those when implementing targeted corrective measures. Although further studies are required to confirm our findings, this study could be the ground for a medication waste management national strategy in Lebanon.

Cognitive impairment is a prevalent outcome of stroke, affecting the quality of life and increasing the disability. Its risk factors are unknown in Lebanon. Therefore, the aims of this study were to evaluate the cognitive impairment incidence among Lebanese stroke survivors at 3, 6 and 12 month post stroke, and to identify the associated factors. A multicenter longitudinal prospective study was conducted in 10 hospitals of Beirut and Mount Lebanon among 150 subjects aged ≥ 18 years old between February 2018 until May 2019. The Mini-Mental State Examination assessed the cognitive function. Univariate and Multivariable analyses were performedto identify the predictors of the post stroke cognitive impairment. A p-value <0.05 was considered statistically significant. At 3 month post stroke, 74.8% were cognitively impaired versus 46.7% and 37.6% at 6 and 12 month post stroke respectively. Older age, past smoking, presence of a caregiver, sedentary ≥ 12 hours, aphasia at the time of stroke occurrence, the length of hospital stay, severe stroke, high disability degree, post stroke anxiety and depression, epileptic seizures and physical disorders were the risk factors inducing cognitive decline. Whereas, the high education level, the employment and the history of diabetes mellitus played a protective role for the cognitive function. Findings reveal levels of cognitive impairment post-stroke that are concerning. Thus, primary and secondary prevention is essential to reduce its incidence and to cope with its burden.

Background This study objective was to evaluate the prevalence as well as factors (smoking, internet addiction, social phobia, depression, child abuse and bullying) associated with alcohol use disorder among a representative sample of Lebanese young people, in addition to validating and confirming psychometric properties of the AUDIT scale. Methods A cross-sectional study, conducted between January and May 2019, enrolled 1810 adolescents aged between 14 and 17. Alcohol dependence was defined as a high AUDIT score. A principal component analysis technique to confirm the validity of the construct of the AUDIT scale score was done and a confirmatory analysis to assess the structure of the instrument was conducted. Results The mean AUDIT score was 6.46 ± 8.44 and high risk of hazardous alcohol drinking was found in 28% of adolescents. One factor solution of the AUDIT scale had been found after running the factor analysis and the confirmatory factor analysis demonstrated that the χ2/df=2.4, the Steiger-Lind RMSEA was 0.10 [0.084-0.155] and the Joreskog GFI equaled 0.91 and AGFI equaled 0.92. Higher cigarette (Beta=0.372) and waterpipe (Beta=0.319) dependence, higher child sexual (Beta=0.581) and neglect (Beta=0.106) abuse, higher internet addiction (Beta=0.088), separated parents compared to living together (Beta=3.202) and higher bullying victimization (Beta=0.143) were significantly associated with higher AUDIT scores. Conclusion Alcohol dependence seems to be influenced by several risk factors among the Lebanese adolescents such as cigarette and waterpipe dependence, higher internet addiction, bullying, and child sexual and neglect abuse. Parents and healthcare professionals could use this data to influence intervention efforts.

Background Lebanon has been recognized as a center for high-quality healthcare services in the Middle East because of its prestigious facilities certified by international bodies, competent health workers, and credible pharmaceutical sector. This study assessed the professional situation of the Lebanese pharmaceutical workforce upon graduation and entry to the job market. It also evaluated the satisfaction of pharmacists with the financial, physical, and psychological aspects of their job and the effect of the current socioeconomic crisis on their profession. Methods A cross-sectional study was performed between January and May 2021 among 114 Lebanese pharmacists from all pharmaceutical sectors across Lebanon. A self-administered questionnaire was elaborated to assess the pharmaceutical workforce in Lebanon. The online questionnaire was built using Google Forms and disseminated via emails and social platforms. Results Fresh graduates seemed more oriented toward community pharmacies, and 78.1% of the participants worked at least once in their lifetime in a community pharmacy. Pharmacists from the public university worked predominantly in the community pharmacy sector, while those who graduated from private universities worked mainly as medical representatives. Hospital pharmacy comprised significantly more PharmD graduates than other sectors; medical representatives had mainly a BS pharmacy, while those working as industrial pharmacists had a Master’s degree. A low percentage (31.6%) of participants found it easy to get hold of a job across different pharmaceutical sectors while 64.0% considered the internships experience insufficient to get employed. Nearly half (48.2%) of the respondents were poorly satisfied with their job, and 54.0% of community pharmacists reported not working in their preferred field compared to 39.1% of pharmacists from other sectors. Also, 65.79% felt that the economic crisis and the consequent medication shortages affected their credibility and how society perceived them. About half (45.61%) of the participants reported that their employment status was not affected by the crisis; the rest got a second job to cover their expenses (15.79%) or changed jobs (14.91%). Conclusion Our study findings revealed that most Lebanese fresh graduates worked as community pharmacists, which does not correspond to their preference, the available job market, and the modern pharmacy wingspan. Most pharmacists were also financially, physically, and emotionally dissatisfied due to the Lebanese economic crisis that added heavy workloads and responsibilities without any financial raise.

ObjectivesThis study investigated parental knowledge, attitudes and practices towards fever in preschool children to help address gaps in public health and provide information with the aim of supporting clinical reports for parental education.DesignA cross-sectional study design was used to explore parental experiences with fever.SettingParticipants were recruited randomly from schools all over Lebanon targeting the preschool divisions.ParticipantsParents of children aged 5 years or less.InterventionsAn electronic self-administered questionnaire was sent to the parents through the schools’ emails and e-learning mobile applications.Primary and secondary outcomesThe primary outcome measure was to assess parental knowledge about the precise definition of fever, correct use of medications and to evaluate the impact of sociodemographic factors on this knowledge. The secondary outcome measures were to assess parental attitudes and practices of fever management, sources of information and reasons to seek primary medical attention.ResultsA total of 733 parents were included in the study. Only 44% identified fever correctly according to the recognised definition by international guidelines. A significant association between parents’ knowledge of antibiotics and years of parenting experience was found (adjusted OR, ORa=4.23, 95% CI 1.41 to 12.68, p=0.01). Other sociodemographic factors that were significantly associated with parents’ knowledge of antibiotics were age (ORa=3.42, 95% CI 1.09 to 10.73, p=0.036) and education level (ORa=7.99, 95% CI 3.71 to 17.23, p<0.001). Greater than 75% usually give their children antipyretics without consulting a doctor. Approximately one-quarter of parents (26.3%) consulted different doctors at the same time, of which more than half (58.4%) had received different medical information.ConclusionsThis research determines deficiencies in parents’ knowledge of fever with some malpractices in its management particularly regarding antipyretic use. It provides insight for healthcare providers to empower parental experiences by offering the necessary information to enhance general outcomes of febrile sickness.

BackgroundAsthma is a prevalent hyperactive airway disease with physical and emotional impact. Severe asthma is associated with considerable health-related quality of life (HRQoL). The aim of this study is to assess the quality of life through physical, emotional, social and occupational aspects and evaluate the factors affecting HRQoL in patients with asthma.MethodsThis is a cross-sectional multicenter study conducted on adult asthmatic patients enrolled from community pharmacies across different Lebanese geographic areas.ResultsHaving wheezing sometimes and most of the time (Beta = −0.144 and −0.552), experiencing anxiety sometimes and most of the time (Beta = −0.205 and −0.573), encountering sleep problems sometimes and most of the time (Beta = −0.270 and −0.553), having previous chest discomfort sometimes and most of the time (Beta = −0.421 and −0.713), and having depression most of the times (Beta = −0.415) were associated with higher lower quality of life scores. On the other side, holding a secondary level of education was associated with a higher quality of life score (Beta = 0.192).ConclusionThis study highlights that asthma affects adults' quality of life through social, emotional, physical, and occupational impacts. Improved follow-up and patient education may be essential in the future to stop disease progression and achieve ideal therapeutic outcomes.