Risk factors for incident shoulder soft tissue rheumatic disorders: a population-based case–control study in Lebanon

Background: Soft tissue rheumatic disorders [STRDs] are very common and impact enormously general population, working groups and physiotherapist practices. However, they do not have neither a clear case definition nor objective tests to be accurately diagnosed rendering them neglected with poorly-estimated burden. Shoulder is one of the most frequent sites for STRDs.

Aim: The aim of this study was to identify risk factors for shoulder STRDs among Lebanese adults aged . 15 years.

Methods: A case.control study was designed based on data from the Community Oriented Program for Control of Rheumatic Diseases [COPCORD] study conducted in Lebanon in 2009. Cases were defined as those who recently suffered from shoulder pain, tenderness or stiffness with duration not exceeding 12 months [52 cases]. These were frequency-matched by age and gender with 208 controls who never experienced any musculoskeletal pain.

Results: Area of residence, physical activity, family history and stress-induced sleep difficulty were significantly associated with shoulder STRDs after adjusting for cigarette smoking, job nature and family monthly income.

Conclusion: Factors associated with shoulder STRD among the Lebanese population include geographical location, psychosocial factors, physical activity and familial predisposition. Further longitudinal studies are needed to establish a temporal sequence and explore other potential determinants, especially among the working population

Extracurricular activities associated with stress and burnout in preclinical medical students

This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire [GHQ-12] while that of burnout was measured through the Maslach Burnout Inventory-Student Survey [MBI-SS]. The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress [62%] and burnout [75%]. Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study

Fluctuations in glycosylated hemoglobin [HbAlC] as a predictor for the development of diabetic nephropathy in type 1 diabetic patients

The incidence of diabetic nephropathy is higher in type 1 diabetic patients with associated risk factors. The within individual fluctuations in HbAlC and its effect on the development of nephropathy was not previously studied. The purpose of this study is to examine whether HbAlC fluctuations are a predictor of the development of diabetic nephropathy independent of mean HbAlC and other risk factors. One hundred and seventeen patients [64 females and 53 males] were recruited and followed up regularly at least every 3 months. The [fluctuations] in HbAlC over time was assessed. HbAlC fluctuation was defined as an increase in HbAlC of more than 2% between two consecutive measurements, or an increase of more than 1% at 2 points in time. Incipient nephropathy was present in 18 and absent in 99 patients. Mean HbAlC was significantly higher in nephropathy than in non-nephropathy patients. The effect of fluctuations on nephropathy appeared to be more significant in patients with poor metabolic control [HbAlC >/= 8%]. T1D patients who have a similar mean HbAlC may progressively behave differently in terms of developing nephropathy, depending on the fluctuations in HbAlC. This effect seems to be more pronounced among those who have higher values of HbAlC

Patterns of mental illness from psychiatrists' caseloads in different wartime periods

The purpose of the study was to describe patterns of mental illness of those who sought psychiatric services during a five-year period [1985-1991] and to relate such patterns to socio-demographic variables and periods of war violence. The sample consisted of 364 patients coming for their first visit and selected from three psychiatric clinics in Beirut. The results showed that the largest proportion of psychiatric attendance was due to depression. A higher proportion of females sought psychiatric care. Attendance for different disorders varied by age and marital status. The findings also suggested a relationship between war cycles and psychiatric illnesses. The proportion of patients with depression and anxiety increased in post violence periods