[Substance use among Lebanese university students: prevalence and associated factors]. / Consommation de substances psychoactives des étudiants universitaries libanais: prevalence et facteurs associés.

Scientific research on use and misuse of substances in Lebanon is scarce. This study aimed to evaluate the rate of use and abuse of substances among Lebanese youth and identify the determinants and risk factors behind these behaviours. An observational survey was conducted on 1945 university students selected from the different faculties of the Lebanese University and other private universities. A self-administered questionnaire based on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) was administered. The prevalence of ever consuming alcohol was 20.9%. Cannabis (12.3%) and tranquilizers (11%) had the highest rates of ever use among the drugs, whereas cocaine (3.3%) and hallucinogens (3.6%) had the lowest rates. Smoking cigarettes and waterpipes, going out at night, peer pressure and having no specific leisure time activity were associated with problematic substance use, while a better relationship with parents, reading and working were inversely associated with use. There is a high prevalence of substance use among university students in Lebanon. Multidisciplinary support for addicted students is needed to meet their diverse needs.

[Asthma, indoor and outdoor air pollution: A pilot study in Lebanese school teenagers]. / Asthme, pollutions intérieure et extérieure: étude pilote chez des adolescents libanais scolarisés.

INTRODUCTION: Many studies have demonstrated that outdoor pollution might exacerbate respiratory symptoms and childhood asthma. Our objective was to evaluate the relationship between asthma and outdoor and indoor pollution. METHODS: We undertook a survey in May-June 2012 about schoolchildren aged 12-19 years in six Lebanese schools. This combined the International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaire with other questions addressing outdoor and indoor exposure. RESULTS: Among 717 subjects (response rate 71.7%), 4.5% had physician-diagnosed asthma, 34.7% had probable asthma and 60.8% were asymptomatic. Exposure to indoor contaminants was positively associated to asthma. The risk for asthma was higher in those residing near heavy road traffic (ORa=4.30 [95% CI 1.45-12.71], P<0.05), those previously exposed to fire (ORa=1.84 [95% CI 1.01-3.36]), and those exposed to smog (ORa=4.15 [95% CI 1.42-12.12]). Airing the house in the morning or in case of indoor smoking had a protective effect against asthma. CONCLUSION: These results suggest that the risks of asthma or having respiratory symptoms are not only related to indoor pollution but also to outdoor pollution especially from road traffic.

[Current status of nosocomial infections in the Lebanese Hospital Center, Beirut]. / Aspects actuels des infections nosocomiales au Centre Hospitalier Libanais de Beyrouth.

Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Escherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively). The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.

Drug-related problems identified by clinical pharmacist's students and pharmacist's interventions.

BACKGROUND: Drug-related problems constitute a major public health problem, because of their consequences on morbidity, mortality and cost. PATIENTS AND METHODS: A 6-month prospective study was conducted, including hospitalized patients in the internal medicine ward of the University Hospital of Beirut, in order to identify drug-related problems by clinical pharmacist's students participating in routine medical rounds, to assess the characteristics of patients presenting these drug-related problems and to analyze pharmacist's interventions. RESULTS: Ninety patients presenting drug-related problems were identified. Thirty-two percent were hydro-electrolytic problems and 24% gastrointestinal. Cardiovascular drugs were the most frequently implicated (44%), followed by anticoagulants (17%) and corticosteroids (14%). The most commonly identified drug-related problems were drug interactions (37%), overdosage (28%), non-conformity to guidelines or contra-indications (23%), underdosage (10%) and improper administration (2%). The clinical pharmacist's interventions consisted of dose adjustment (38%), addition drugs (31%), changes in drugs (29%) and optimization of administration (2%). DISCUSSION AND CONCLUSION: To decrease the risk of drug-related problems, drug treatment requires physicians to abide by prescribing recommendations, notably in elderly patients, as well as pharmacists' effective intervention at all levels. Routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of drug-related problems and may prevent their occurrence.

Current status of nosocomial infections in the Lebanese Hospital Center, Beirut

Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections [42%] followed by pulmonary infections [28%]. Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Esherichia coli and Pseudomonos alrogenosa being the most common [46% and 26% respectively] The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms

[Which factors are associated to hemorrhagic adverse drug events related to antivitamin K?]. / Quels facteurs associés à la survenue d'un événement iatrogène hémorragique chez les patients sous antivitamines K ?

INTRODUCTION: Hemorrhagic events constitute a major risk for patients on oral anticoagulant therapy. PATIENTS AND METHODS: We conducted a prospective survey of all patients taking oral anticoagulants and admitted to the emergency room of Grenoble University Hospital over a period of 10 months. The objective was to identify the causes of drug-induced adverse hemorrhagic events, and whether they were related to health care practices or patient behavior concerning their treatment. RESULTS: Two hundred and sixteen patients treated with oral anticoagulants were identified and 68 of them had a hemorrhagic adverse drug event. Not taking into account prior medial history before prescribing an anticoagulant was noted for 21 of the patients who experienced a hemorrhagic event (p = 0.0003). In addition, compared with patients who had not had a hemorrhagic event, inadequate prescribing with regard to doses and administration frequency there were also more common in the hemorrhagic event group (p < 0.0001). Pharmacists delivering the drugs had not intervened to correct drug interactions, contraindications and inadequate doses in 72% of patients with hemorrhage (p < 0.0001). Other factors associated with increased the risk of hemorrhage were self-medication, not taking the prescribed drug at a predefined time of the day, insufficient INR monitoring and poor compliance (p < 0.0001). DISCUSSION AND CONCLUSION: To achieve the beneficial effects expected with anticoagulants, physicians must carefully comply with prescription recommendations, especially for elderly patients. Pharmacists delivering the drugs should also intervene more readily when required.

[Hemorrhagic complications of anti-vitamin K]. / Complications hémorragiques des anti vitamine K: enquête de prévalence aux urgences du CHU de Grenoble.

Adverse events related to oral anticoagulants represent a major public health problem. Hemorrhagic episodes are the most frequent complications and can be life-threatening. A 10 month prospective survey on all cases treated with anti-vitamin K (AVK), and admitted to emergency room of CHU Grenoble, was conducted to identify the hemorrhagic adverse drug events (HADE). The evaluation support was a directive questionnaire and consisted of 3 parts: patient characteristics, patient's medicated treatment and the hemorrhagic event. 216 patients treated with AVK were identified and 68 of them presented a hemorrhagic adverse drug event. 60 patients older than 65 years out of 158, presented HADE (38%); versus 8 patients < or = 65 years out of 58 (RR = 2.75; p = 0.0007). Among the patients who have their INR > or = 5, 79% developed HADE versus 16% in the group who had their INR < 5 (< 0.0001). In the group of patients who had a change in drug therapy within the 7 days preceding their admission, 47% developed HADE versus 25% of patients whose treatment was not modified: Anti-microbial agents were the drug most frequently involved. The patient's knowledge of INR value and signs of excess AVK were significant. Concerning missed dose, 48 patients declared taking the missed dose with the next dose or when they remembered: 35% of them developed HADE (p = 0.49).