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Background:  The COVID-19 pandemic negatively affected physical and psychological health worldwide. Pregnant women were likely more vulnerable to mental health difficulties due to the significant social, psychological, and hormonal changes they experience. During the pandemic, higher rates of antenatal depression and anxiety were observed compared to pre-pandemic rates. Increased mental health symptoms in pregnancy have been associated with adverse outcomes for child development. Understanding pandemic-specific preventive behaviours (i.e., mask use, physical distancing) and concerns may also be linked to maternal psychological well-being., Purpose: To compare matched pregnant and non-pregnant women (N = 474) to assess COVID-19 psychosocial impacts, preventive behaviours, and concerns., Methods: This study used a matched analysis of data collected by the International COVID-19 Awareness and Responses Evaluation (iCARE) Study. Participants were matched on several demographic factors and analyses were adjusted for chronic illness and psychiatric disorder., Results: Linear regression analyses indicated that pregnant women did not significantly differ from matched non-pregnant women for psychosocial impacts (B = 0.11, SE = 0.08, p = 0.178). Those who reported a chronic illness (B=-0.19, SE = 0.09, p = 0.036) or a psychiatric disorder (B=-0.28, SE = 0.09, p = 0.003) were more likely to report more significant psychosocial impacts. Logistic regression analyses indicated that pregnant women were more likely to report staying at home rather than going to work (OR = 2.01, 95% CI 1.31-3.08, p = 0.002) and being concerned about being infected (OR = 1.61, 95% CI 1.05-2.46, p = 0.028)., Conclusions: Our findings in the context of the COVID-19 pandemic highlight the need to consider interventions targeting women, with chronic illnesses or psychiatric disorders, as they are often the most vulnerable., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

This paper deals with fault detection and isolation (FDI) in complex embedded wired communication networks. The considered faults are soft faults which do not prevent the communication, but may evolve into hard faults, i.e. short or open circuit. A novel FDI method based on power line communication (PLC) transmission systems is proposed. In these PLC systems, the transmission coefficients between the source and each receiver are estimated for communication purposes using orthogonal frequency division multiplexing (OFDM). Health indicators and residuals are computed by comparing the online estimated transmission coefficients with the reference coefficients. A methodology for dealing with complex networks, such as bus networks, is proposed. It is based on the decomposition of the network into several Y-shaped sub-networks. Each of these sub-networks is monitored to detect the presence of a fault. The FDI method is first validated using real data extracted from a Y-shaped network test bench. Then, the proposed approach is validated on a more complex network using realistic simulated data., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 ISA. Published by Elsevier Ltd. All rights reserved.)

Southern Gabes aquifer is part of coastal Jeffara plain located in southeastern Tunisia. It consists a semi-arid area in which groundwater is the main source to water supply for several socio-economic sectors. Southern Gabes aquifer suffers from excessive abstraction and heavy anthropogenic pressures that make local groundwater resources threatened by pollution risks. This study aims to assess groundwater vulnerability, evaluate, and delineate groundwater risk regions. For this, a 17 water samples were carried out in the study area and chemical compositions were analyzed. A well-known AVI model has been used to assess aquifer vulnerability and new algorithms of sensitivity to pollution index (PSI) and risk groundwater to pollution index (RGPI) were implemented and used to assess, classify, and map groundwater pollution risk. Results reveal that study area suffers from high risk. Forty one percent of the total surface of study area has a very high risk. Nonetheless, only 30% of study area has a low to insignificant risk to pollution which necessitates taking severe precautions to protect the southern Gabes aquifer system. The method used in this study seems giving more precise results compared to conventional approaches. Moreover, this method allows assessing the pollution risk with flexible and reliable algorithm even with limited dataset. Hence, the poor natural protective capacity of study area needs a rapid intervention by local authorities in order to develop proactive solutions to protect and preserve groundwater resources from pollution risks and establish a long-term program for groundwater resources sustainable development., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Suicide is a leading preventable cause of mortality worldwide. Suicide rates in Lebanon are unknown, as reported numbers are extrapolated and modeled over neighboring countries with poor quality of vital registration data., Methods: Numbers of death by suicide were obtained from the Internal Security Forces records from January 2008 through December 2018. Records from 2011 through 2018 specified the gender of the individual, the means of the suicide, the date and place of suicide. As of March 2014, nationality of the individual was recorded., Results: The total recorded number of completed suicides over 11 years is 1366 with an annual rate ranging between 1.87 and 2.4 per 100,000 capita. The male to female ratio was 2:1. Death by firearms (41.4 %) was the most common means used, followed by hanging (26.5 %), jumping from a height (13.6 %), and poisoning (13.5 %). Males were more likely to use firearms while females were more likely to use hanging or jumping from a height (p < 0.001), the latter being a common finding in non-Lebanese nationals (Ethiopian). Suicides were most common in Mount Lebanon and least common in Nabatieh governates, while their distribution across seasons was similar., Conclusion: In Lebanon, like most of the Middle Eastern countries, suicide is a social and religious taboo. Our study shows a sizable prevalence of suicide rates, particularly after national efforts to improve awareness and reporting. Suicide means and vulnerable populations should be at the heart of targeted prevention strategies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Persistent left superior vena cava (PLSVC) is one of the most frequently reported congenital anomalies and may be an important source of trigger of atrial fibrillation (AF)., Methods: This was a multicenter retrospective experience including 28 patients with PLSVC who were referred for catheter ablation for drug-refractory symptomatic AF. Pulmonary vein and PLSVC isolation were performed (3.5-mm open irrigated tip ablation catheter at maximum power of 20 W, maximum temperature 43 °C with flow rate of 17 ml/min). Clinical outcomes such as complications and long-term freedom from AF were measured., Results: The mean age of the population was 61 ± 8 years, 21% were females, and AF duration was 60 ± 33 months. Sixty-one percent paroxysmal AF (17/28), 25% (7/28) persistent AF, and 14% (4/28) had long-standing persistent AF. There were no major complications that required any intervention. PLSVC isolation was achieved in 96% (27/28). Freedom from AF at 1 year without antiarrhythmic drugs was seen in 75% (21/28) of patients., Conclusions: In PLSVC patients with AF, segmental isolation of PLSVC appears to be feasible and safe and can translate into favorable clinical outcomes.

Background: Schizophrenia is often associated with poor clinical insight (unawareness of mental illness and its symptoms) and deficits in empathy, which are important for social functioning. Cognitive empathy has been linked to clinical insight while affective empathy and its role in insight and pathology have received mixed evidence., Methods: Instruments assessing symptomatology (Positive and Negative Syndrome Scale; PANSS), clinical insight (Scales to assess awareness of mental disorders; SUMD), and cognitive and affective empathy were administered to 22 participants with first episode and chronic schizophrenia and 21 healthy controls. Self-report, parent-report, and performance based measures were used to assess cognitive and affective empathy (The interpersonal reactivity index; IRI/Reading the Mind in the Eyes Test/Faux Pas) to reduce bias and parse shared variance., Results: Age of onset, gender, and symptomatology emerged as significant predictors of poor clinical insight. Additionally, the fantasy subscale of the IRI as reported by parents emerged as a positive predictor while the personal distress (parent report) subscale emerged as a negative predictor of awareness into mental illness. There were significant differences on performance-based measures of empathy between the control and schizophrenia groups., Conclusion: Findings suggest that affective empathy is relatively intact across phases of illness whereas cognitive empathy abilities are compromised and could be targets for psychotherapy intervention.

Background: Use of corticosteroids before and after atrial fibrillation (AF) ablation can decrease acute inflammation and reduce AF recurrence., Purpose: To assess the efficacy of oral prednisone in improving the outcomes of pulmonary vein isolation with radiofrequency ablation and its effect on inflammatory cytokine., Methods: A total of 60 patients with paroxysmal AF undergoing radiofrequency ablation were randomized (1:1) to receive either 3 doses of 60 mg daily of oral prednisone or a placebo. Inflammatory cytokine levels (TNF-α, IL-1, IL6, IL-8) were measured at baseline, prior to ablation, immediately after ablation, and 24 hours post ablation. Patients underwent 30 day event monitoring at 3 months, 6 months and 12 months post procedure., Results: Immediate post ablation levels of inflammatory cytokines were lower in the steroid group when compared to the placebo group; IL-6: 9.0 ±7 vs 15.8 ±13 p=0.031; IL-8: 10.5 ±9 vs 15.3 ±8; p=0.047 respectively. Acute PV reconnection rates during the procedure (7/23% vs 10/36%; p = 0.39), and RF ablation time (51±13 vs 56±11 min, p = 0.11) trended to be lower in the placebo group than the steroid group. There was no difference in the incidence of early recurrence of AF during the blanking period and freedom from AF off AAD at 12 months between both groups (5/17% vs 8/27%; p = 0.347 and 21/70% vs 18/60%; p=0.417 in placebo and steroid groups respectively)., Conclusion: Although oral corticosteroids have significant effect in lowering certain cytokines, it did not impact the clinical outcomes of AF ablation.

Background: In the stroke prevention trials of left atrial appendage closure with the Watchman device (Boston Scientific), a postimplantation antithrombotic regimen of 6 weeks of warfarin was used., Objective: Given the clinical complexity of warfarin use, the purpose of this study was to study the relative feasibility and safety of using non-warfarin oral anticoagulants (NOACs) instead of warfarin during the peri- and initial postimplantation periods after Watchman implantation., Methods: This was a retrospective multicenter study of consecutive patients undergoing Watchman implantation and receiving peri- and postprocedural NOACs or warfarin. Transesophageal echocardiography or chest computed tomography was performed between 6 weeks and 4 months postimplant to assess for device-related thrombosis. Bleeding and thromboembolic events also were evaluated at the time of follow-up., Results: In 5 centers, 214 patients received NOACs (46% apixaban, 46% rivaroxaban, 7% dabigatran, and 1% edoxaban) in either an uninterrupted (82%) or a single-held-dose (16%) fashion. Compared to a control group receiving uninterrupted warfarin (n = 212), the rates of periprocedural complications, including bleeding events, were similar (2.8% vs 2.4%, P = 1). At follow-up, the rates of device-related thrombosis (0.9% vs 0.5%, P = 1), composite of thromboembolism or device-related thrombosis (1.4% vs 0.9%, P = 1), and postprocedure bleeding events (0.5% vs 0.9%, P = .6) also were comparable between the NOAC and warfarin groups., Conclusion: NOACs proved to be a feasible peri- and postprocedural alternative regimen to warfarin for preventing device-related thrombosis and thromboembolic complications expected early after appendage closure with the Watchman device, without increasing the risk of bleeding., (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: Luminal esophageal temperature monitoring is performed with a variety of temperature probes, but little is known about the relationship between the structure of a given probe and its thermodynamic characteristics., Objective: The purpose of this study was to evaluate the difference in thermodynamics between a 9Fr standard esophageal probe and an 18Fr esophageal stethoscope., Methods: In the experimental setting, each probe was submerged in a constant temperature water bath maintained at 42°C; in the patient setting, we monitored the temperature with both probes at the same time., Results: The time constant of the stethoscope was higher than that of the probe (33.5 vs 8.3 s). Compared to the probe, the mean temperature measured by the stethoscope at 10 seconds was significantly lower (22.5°C ± 0.4°C vs 33.5°C ± 0.3°C, P<.0001), whereas the time to reach the peak temperature was significantly longer (132.6 ± 5.9 s vs 38.8 ± 1.0 s, P<.0001). Even in the ablation cases we observed that when the esophageal probe reached a peak temperature of 39.6°C ± 0.3°C, the esophageal stethoscope still displayed a temperature of 37.3°C ± 0.2°C (a mean of 2.39°C ± 0.3°C lower, P<.0001), showing a <0.5°C increase in temperature half of the times., Conclusion: The 18Fr esophageal stethoscope has a significantly slower time response compared to the 9Fr esophageal probe. In the clinical setting, this might result in a considerable underestimation of the luminal esophageal temperature with potentially fatal consequences., (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: The goal of this study is to assess the effect of cardiac resynchronization therapy (CRT) over time on renal function and its impact on mortality. The effect of CRT on renal function in patients with heart failure is not well understood., Methods: All patients who underwent CRT implantation at University of Kansas between year 2000 and 2009 were reviewed and patients who had pre and post CRT renal function studied were included in our study. Stages of chronic kidney disease (CKD) were defined based on Kidney Disease Outcome Quality Initiative (KDOQI) guidelines. The effect of CRT on renal and cardiac function were studied at short term (≤6 months post implantation) and long term (>6 months)., Results: A total of 588 patients with mean age of 67 ± 12 yrs were included in the study. CRT responders (defined by increase in LVEF ≥ 5%) were 54% during short term follow-up and 65% on long term follow-up. When compared to baseline, there was no significant deterioration in mean Glomerular Filtration Rate (GFR) during follow up. When analyzed based on the stages of CKD, there was significant improvement of renal function in patients with advanced kidney disease. Multivariate logistic regression analysis showed that stable GFR or an improvement in GFR independently predicted mortality after adjusting for co-morbidities., Conclusions: CRT was associated with stabilization of renal function in patients with severe LV dysfunction and improvement in stage 4 and 5 CKD. Improved renal function was associated with a lower mortality., (Copyright © 2016 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.)

Background: The diagnostic value of the Athens QRS score to detect obstructive coronary artery disease CAD in patients with otherwise normal exercise stress test remains unclear., Methods and Results: We analyzed 458 patients who underwent exercise stress test with or without myocardial perfusion imaging within 2 months of coronary angiography from 2008 to 2011. Patients (n=173) with abnormal stress test based on ST segment criteria were excluded. The Athens QRS score ≤5 was defined as abnormal. In our study cohort, 285 patients met the inclusion criteria and were divided into 2 groups: low Athens QRS score (LQRS, n=56), with QRS score ≤5 and normal Athens QRS score normal Athens QRS score, n=229), with QRS score >5. The presence of single-vessel and multivessel obstructive CAD was higher in LQRS than in normal Athens QRS score patients (47% versus 7.5% and 30% versus 3.8%, respectively, all P<0.001). Logistic regression analysis showed that the likelihood of CAD was strongly and independently associated with LQRS (odds ratio=36.81, 95% CI: 10.77-120.47), diabetes (odds ratio=6.49, 95% CI: 2.41-17.49), lower maximum heart rate (odds ratio=0.92, 95% CI: 0.88-0.95, all P<0.001), and older age (odds ratio=1.93, CI: 1.88-1.97, P=0.002)., Conclusions: In a clinical cohort of patients with chest pain and normal exercise stress test, LQRS score is a strong independent predictor of presence of CAD. LQRS patients have a 6-fold higher prevalence of CAD and may warrant further evaluation even with reassuring exercise stress test., (© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)

The Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. The aim of this study is to translate the screening tools into Arabic and evaluate their psychometric properties in an Arabic-speaking Lebanese psychiatric outpatient sample. The patients completed the questionnaires, among others, prior to being evaluated by a clinical psychiatrist or psychologist. The scales' internal consistency and factor structure were measured and convergent and discriminant validity were established by comparing the scores with clinical diagnoses and the Psychiatric Diagnostic Screening Questionnaire - MDD subset (PDSQ - MDD). Results showed that the PHQ-9 and GAD-7 are reliable screening tools for depression and anxiety and their factor structures replicated those reported in the literature. Sensitivity and specificity analyses showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither sensitive nor specific at capturing anxiety symptoms. The implications of these findings are discussed in reference to the scales themselves and the cultural specificity of the Lebanese population., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Although current lead design and filtering capabilities have greatly improved, Electromagnetic Interference (EMI) from environmental sources has been increasingly reported in patients with Cardiac Implantable Electronic Device (CIED) [1]. Few cases of inappropriate intracardiac Cardioverter Defibrillator (ICD) associated with swimming pool has been described [2]. Here we present a case of 64 year old male who presented with an interesting EMI signal that was subsequently identified to be related to AC current leak in his swimming pool.

Introduction: Left atrial appendage (LAA) can be effectively and safely excluded using a novel percutaneous LARIAT ligation system. However, due to pericardial catheter manipulation and LAA ligation and subsequent necrosis, postprocedural course is complicated by pericarditis. We intended to evaluate the preprocedural use of colchicine on the incidence of postprocedural pericardial complications., Methods and Results: In this multicenter observational study, we included all consecutive patients who underwent LARIAT procedure at the participating centers. Many patients received periprocedural colchicine at the discretion of the physician. We compared the postprocedural outcomes of patients who received prophylactic periprocedural colchicine (colchicine group) with those who did not receive colchicine (standard group). A total of 344 consecutive patients, 243 in the "colchicine group" and 101 in the "standard group," were included. The mean age, median CHADS2VASc score, and HASBLED scores were 70 ± 11 years, 3 ± 1.7, and 3 ± 1.1, respectively. There were no significant differences in major baseline characteristics between the two groups. Severe pericarditis was significantly lower in the "colchicine group" compared to the "standard group" (10 [4%] vs. 16 [16%] P<0.0001). The colchicine group, compared to the standard group, had lesser pericardial drain output (186 ± 84 mL vs. 351 ± 83, P<0.001), shorter pericardial drain duration (16 ± 4 vs. 23 ± 19 hours, P<0.04), and similar incidence of delayed pericardial effusion (4 [1.6%] to 3 [3%], P = 0.42) when compared to the standard group., Conclusion: Use of colchicine periprocedurally was associated with significant reduction in postprocedural pericarditis and associated complications., (© 2015 Wiley Periodicals, Inc.)

Objectives: Despite the psychosocial and physical consequences associated with sickle cell disease (SCD), the daily lived experience of adolescents diagnosed with this disease is a phenomenon rarely described. The objective of this study was to explore the daily lived experience of adolescents with SCD living in Lebanon., Method: Twelve adolescents with SCD between the ages of 12 and 17 years were interviewed with use of a semi-structured interview during a routine follow-up visit after they were assessed as being pain free. Interviews were transcribed verbatim, and thematic analysis was conducted., Results: Adolescents with SCD experience a layered burden consisting of physical, emotional, and sympathetic pain that affects much of their daily personal and social lives. Nevertheless, they seem to claim normalcy and to downplay their pain and suffering in order to limit their caregivers' distress., Conclusion: These findings can be used to assist health care providers in designing culturally sensitive interventions specifically designed for adolescents with SCD and their families to enable them to better cope with their illness., (Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Atrial fibrillation (AF) is associated with increased rates of death, stroke, heart failure, hospitalization, degraded quality of life, reduced exercise capacity, and left ventricular dysfunction. An oral anticoagulant reduces the risk of stroke; however, it places the patient at risk for bleeding complications. Weighing the stroke and bleeding risks remains the key for optimal treatment. Cardiac interventions that can obviate long-term oral anticoagulation hold great promise for the future care of patients with AF and high stroke risk. The percutaneously deployable Watchman device is a paradigm shift in how clinicians can abate the need for continued oral anticoagulation., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: A dry epicardial access (EA) is increasingly used for advanced cardiovascular procedures. Conventionally used large bore needles (Tuohy or Pajunk needle; LBN) have been associated with low but definite incidence of major complications with EA. Use of micropuncture needle (MPN) may decrease the risk of complications. We intended to compare the outcomes of LBN with MPN for EA., Methods and Results: We report a multicenter observational study of consecutive patients who underwent EA for ventricular tachycardia ablation or Lariat procedure using the LBN or MPN. Oral anticoagulation was stopped before the procedure. Baseline characteristics and procedure-related complications were collected and compared. Of the 404 patients, LBN and MPN were used in 46% and 54% of patients, respectively. There was no significant difference in the incidence of inadvertent puncture of myocardium between LBN and MPN (7.6% versus 6.8%, P=0.76). However, there was a significantly higher rate of large pericardial effusions with LBN compared with MPN (8.1% versus 0.9%; P<0.001). The incidence of pleural effusions were not significantly different between both (1.6% versus 2.3%; P=0.64). LBN group had an increase in other complications compared with MPN (open heart surgery to repair cardiac laceration [6 versus 0], injury to liver [1 versus 0], coronaries [1 versus 0], and superior epigastric artery requiring surgical exploration [0 versus 1])., Conclusions: The use of MPN is associated with decreased incidence of major complications, and the need for surgical repair and routine use should be considered for EA., (© 2015 American Heart Association, Inc.)

Radiofrequency ablation may prevent or treat atrial and ventricular arrhythmias. Since some of these arrhythmias are associated with sudden cardiac death, it has been hypothesized that ablation may prevent sudden death in certain cases. We performed a literature search to better understand under which circumstances ablation may prevent sudden death and found little randomized data demonstrating the long-term effects of ablation. Current literature shows that ablation clearly prevents symptoms of arrhythmia and may reduce the incidence of sudden cardiac death in select patients, although data does not indicate improved mortality. Ongoing clinical trials are needed to better define the role of ablation in preventing sudden cardiac death.

Background: Major depressive disorder has been associated with abnormal resting-state functional connectivity (FC), especially in cognitive processing and emotional regulation networks. Although studies have found abnormal FC in regions of the default mode network (DMN), no study has investigated the FC of specific regions within the anterior DMN based on cytoarchitectonic subdivisions of the antero-medial pre-frontal cortex (PFC). Studies from different areas in the field have shown regions within the anterior DMN to be involved in emotional intelligence. Although abnormalities in this region have been observed in depression, the relationship between the ventromedial PFC (vmPFC) function and emotional intelligence has yet to be investigated in depressed individuals., Methods: Twenty-one medication-free, non-treatment resistant, depressed patients and 21 healthy controls underwent a resting state functional magnetic resonance imaging session. The participants also completed an ability-based measure of emotional intelligence: the Mayer-Salovey-Caruso Emotional Intelligence Test. FC maps of Brodmann areas (BA) 25, 10 m, 10r, and 10p were created and compared between the two groups., Results: Mixed-effects analyses showed that the more anterior seeds encompassed larger areas of the DMN. Compared to healthy controls, depressed patients had significantly lower connectivity between BA10p and the right insula and between BA25 and the perigenual anterior cingulate cortex. Exploratory analyses showed an association between vmPFC connectivity and emotional intelligence., Conclusions: These results suggest that individuals with depression have reduced FC between antero-medial PFC regions and regions involved in emotional regulation compared to control subjects. Moreover, vmPFC functional connectivity appears linked to emotional intelligence., (© The Author 2015. Published by Oxford University Press on behalf of CINP.)

Introduction: Use of electroconvulsive therapy (ECT) is limited by cognitive disturbance. Focal electrically-administered seizure therapy (FEAST) is designed to initiate focal seizures in the prefrontal cortex. To date, no studies have documented the effects of FEAST on regional cerebral blood flow (rCBF)., Methods: A 72 year old depressed man underwent three single photon emission computed tomography (SPECT) scans to capture the onset and resolution of seizures triggered with right unilateral FEAST. We used Bioimage Suite for within-subject statistical analyses of perfusion differences ictally and post-ictally compared with the baseline scan., Results: Early ictal increases in regional cerebral blood flow (rCBF) were limited to the right prefrontal cortex. Post-ictally, perfusion was reduced in bilateral frontal and occipital cortices and increased in left motor and precuneus cortex., Conclusion: FEAST appears to triggers focal onsets of seizure activity in the right prefrontal cortex with subsequent generalization. Future studies are needed on a larger sample., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Cocaine induced chest pain is a major reason for admission in Safety Net Hospitals in the United States. The majority of patients admitted undergo extensive work-up leading to enormous economic burden. We hypothesize that in individuals with low risk, cocaine does not further increase adverse cardiovascular outcomes., Methods: We conducted a retrospective chart review of all patients admitted with chest pain to our hospital between 07/01/09 and 06/30/10. We excluded patients with modifiable risk factors for coronary artery disease (CAD). The study population was divided into cocaine and non-cocaine group based on urine drug screen. We analyzed data including demographic, laboratory, cardiac testing, detection of CAD, length of stay and mortality rates., Results: A total of 426 individuals matched our inclusion and exclusion criteria and were considered to have no known modifiable cardiac risk factors; 54 in cocaine group and 372 in non-cocaine group. Based on physician discretion, 41(76%) in the cocaine group and 239(64%) in the non-cocaine group underwent various modalities of cardiac testing. Cardiac testing was positive in 6(2.5%) patients in non-cocaine group and none in the cocaine group (p=0.597). There was no significant difference between length of stay and in-hospital mortality between the two groups., Conclusions: In individuals at low risk for CAD, cocaine use resulted in higher rate of cardiac testing. However, there is no difference in prevalence of CAD and in-hospital mortality between the two groups. We conclude that cocaine does not increase adverse outcomes in patients with low risk for CAD.

Objective: The objective of the present study was to assess the prevalence and determinants of preconceptional folic acid supplement use among pregnant women in Lebanon., Design/setting/subjects: The study was a descriptive epidemiological study. Analysis was performed on 5280 deliveries admitted to twelve member hospitals of the National Collaborative Perinatal Neonatal Network during the period September 2003-January 2005. Information on folic acid intake and maternal and neonatal characteristics were obtained from obstetric charts along with direct interviews performed by trained personnel. Logistic regression was performed to determine the predictors of preconceptional folic acid use., Results: The overall use of preconceptional folic acid supplementation was 14.0 % (18.6 % in urban hospitals v. 2.7 % in rural hospitals). Higher socio-economic status, lower parity and having a history of previous spontaneous abortions were significantly associated with preconceptional folic acid use., Conclusion: Our study shows that Lebanon currently has a low rate of preconceptional folic acid supplement use. Intervention through the means of awareness campaigns needs to be implemented on a national level.

Objective: The study aims to determine the prevalence of eczema among Lebanese adolescents and identify demographic, nutritional and environmental characteristics associated with eczema., Methods: A cross-sectional study conducted on a convenient sample of 3 153 students (13-14 years) selected from five different provinces in Lebanon. Significant unadjusted demographic, nutritional and environmental variables were considered in a stepwise regression model., Results: Ever having an itchy rash that lasted for a period more than six months was reported by 788 (25.0%) adolescents, while 404 (12.8%) reported ever having eczema. Females and passive smokers were at 1.5 increased risk of having eczema than their counterparts. Exercising regularly, living near a busy area, and frequent eating of eggs were positively associated with eczema. Finally, adolescents who suffered from allergic diseases, asthma (Odds ratio (OR): 1.64, 95% CI: 1.16-2.32), rhinitis (OR: 1.35, 95% CI: 1.07-1.70) and hay fever (OR: 2.77; 95% CI: 2.12-3.62) also reported having had eczema., Conclusion: Environmental factors were found to play an important role in the prevalence of eczema among adolescents.

Introduction: Limited research has been performed to compare the predictive abilities of the injury severity score (ISS) and the new ISS (NISS) in the developing world., Patients and Methods: From January 2001 until January 2003 all trauma patients admitted to the American University of Beirut Medical Centre were enrolled. The statistical performance of the ISS/NISS in predicting mortality, admission to the intensive care unit (ICU) and length of hospital stay (LOS dichotomised as <10 or > or =10 days) was evaluated using receiver operating characteristic and the Hosmer-Lemeshow calibration statistic., Results: A total of 891 consecutive patients were enrolled. The ISS and NISS were equivalent in predicting survival, and both performed better in patients younger than 65 years of age. However, the ISS predicted ICU admission and LOS better than the NISS. However, these predictive abilities were lower for the geriatric trauma patients aged 65 years and above compared to the other age groups., Discussion: There are conflicting results in the literature about the abilities of ISS and NISS to predict mortality. However, this is the first study to report that ISS has a superior ability in predicting both LOS and ICU admission., Conclusion: The scoring of trauma severity may need to be individualised to different countries and trauma systems.