We report a case of Pseudomonas stutzeri endocarditis in Lebanon. The patient had a recent history of prosthetic aortic valve replacement and presented to the emergency department with fever and chills. Transesophageal echocardiography confirmed the presence of a vegetation on the prosthetic valve and blood cultures yielded P. stutzeri. The patient was treated with surgery and antibiotics but deteriorated and passed away four days after admission. To our knowledge, this is the fifth case of P. stutzeri endocarditis reported in the literature, and the first case with early presentation and mortality.
Background: A waste disposal crisis occurred in Lebanon leading to the accumulation of garbage in the streets of Beirut. It is not clear whether such a limited crisis of improper waste disposal will lead to more diarrhea illnesses. The purpose of this study is to compare the rates of admissions due to diarrhea and characterize the illness among adults and children before, during and after the garbage crisis. Materials and methods: This study is an observational retrospective in-patient chart review extending over four time intervals: pre-crisis, major crisis, minor crisis, and post-crisis periods. Hospital admissions due to diarrhea or gastroenteritis were included. Descriptive analysis of the following was done: characteristics of the present illness at the time of admission, stool and lab tests ordered and management of the diarrhea illness. Results: There was an increase in admission rates due to diarrhea in the months of the crisis as compared to pre and post-crisis months. The severity of diarrheal illness and the management of admitted patients were almost the same across the four periods. Rota virus diarrheal outbreak was noted during the major crisis among children less than 2 years old, and adults above 18 years old. Conclusions: Despite an increase in the rates of admissions due to diarrhea during the garbage crisis, the severity of the diarrhea illness did not differ. This may indicate that physicians and patients were more worried and utilized more health services. However, Rota outbreaks may be more prominent with improper garbage disposal.
Objectives To assess the awareness and have an insight on practice patterns of primary care physicians (PCPs) with respect to several professional primary cardiovascular diseases (CVDs) preventive guidelines. Methods This is a cross-sectional study, questionnaire-based using a non-probability convenience sampling. Data collection occurred at the annual conferences of the Lebanese Societies of General Practice, Family Medicine, and Internal Medicine in Lebanon. 104 PCPs were recruited. Main Outcome Measures Awareness and practices of CVDs preventive guidelines. Results The response rate was 37%. Awareness of the various CVD preventive guidelines was high among PCPs (>81%). Around 69% of PCPs reported that they always calculate the total cardiovascular risk assessment score. Gaps in managing patients according to guidelines’ recommendations were higher in statin initiation compared to antihypertensive initiation. There is over prescription of statin in low risk patients and underutilization in high risk patients. Around 20% of PCPs would initiate aspirin for a low risk patient. Around 17% of physicians do not perform abdominal aortic aneurysm screening. Discussion Although PCPs demonstrated high level of awareness regarding CVD preventive guidelines, gaps remain present in managing patients according to guidelines’ recommendations. Less adherence to guidelines will increase mortality and affect patient care.
Background: Balint seminars are widely used educational activities in family medicine residency programs. However, their impact on measurable outcomes is uneven and controversial. The discussions in Balint seminars deal with perceiving and understanding the emotions of the participants. Objective: This study measures the effect of Balint seminars on the emotional intelligence (EI) and burnout of internal medicine residents at the American University of Beirut. Design: Quasi-experimental observational pretest–posttest study. Setting: In all, 27 internal medicine residents at the American University of Beirut. Methods: Bi-weekly Balint seminars were delivered to internal medicine residents throughout the academic year. EI using Mayer Salovey and Caruso Emotional Intelligence Test (MSCEIT) and burnout level using Maslach Burnout Inventory (MBI) were measured at the beginning and end of the academic year. Results: A total of 20 Balint seminars were delivered. On average, residents attended six sessions with standard deviation ( SD) of 2. Using paired t-tests to compare post- and pre-total EI scores, there was no significant difference between the two scores (mean difference post-pre = -0.6 ± 9.7, p = .738). Gender was the most important predictor of the difference between pre- and post-total EI scores (women are the reference, β = -8.403, p = .007) as compared to understanding emotions baseline score (β = -0.263, p = .003). A significant proportion of residents (22.2%–29.6%) showed severe burnout levels on at least one of the three domains of burnout at baseline; however, Balint seminars did not have any effect on any of the burnout domains. Conclusions: Balint seminars may have the beneficial effect of improving emotional intelligence among women. Balint seminars did not improve the burnout levels of internal medicine residents. Optimizing attendance of the Balint sessions may affect the outcomes attributable to Balint seminars.
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