ABSTRACT
BACKGROUND: Sun exposure is an extrinsic risk factor for skin aging, wrinkle formation, and the development of skin cancer, namely melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Sun protection measures have emerged as an important means of preventing these harmful effects. Studies have shown that sexual minority men have a greater prevalence of skin cancer than heterosexual men. AIMS: There is limited research investigating the reasons behind this risk of skin cancer development. This is especially important because identifying preventable risk factors, like those pertaining to sun exposure behaviors, can be targeted in the fight against skin cancer and help establish screening tools and preventive interventions for the SGM community. This study focused on members of the SGM community and demonstrated their tendency not to use sun-protective measures, as well as their deficits in knowledge of skin cancer prevention. MATERIALS AND METHODS: This study is a cross-sectional study that investigates sun protection practices and trends among adults in Lebanon's SGM community using a survey. It includes adults aged 18-80 that were recruited from the dermatology clinics at AUBMC as well as LGBTQ+ organizations Helm and SIDC. RESULTS: A total of 129 participants took part in the study and completed the survey. Reasons for tanning varied among our participants: tanning to get a color (13.1%), tanning to get vitamin D (4.6%), tanning socially (6.9%), and tanning for mood elevation (0.8%). No significant association was found between sexual orientation and SPF use (p = 0.167). No significant association was found between sexual orientation and tanning frequency during summer (p-value: 0.231). Similarly, no significant association was noted between sexual orientation and tanning bed use (0.951). No significant association was noted between the type of job and SPF use (p = 0.601). Despite no significance between SPF use and the highest educational degree attained (p = 0.070), the tendency to use SPF increased with higher levels of education. Moreover, awareness of sun-induced skin cancer did not significantly affect SPF use (p = 0.067). However, a significant association was found between the information source for skin cancer and SPF use (p < 0.001) where participants receiving information from dermatologists displayed notably higher SPF use (72.2%), compared to those obtaining information from media (18.2%) or family and friends (5.3%). DISCUSSION: Surveying the perception of the Lebanese SGM community towards sun damage and their adaptive practices to prevent it can help implement and gear a nation-wide campaign to spread proper awareness about this subject. Studying their behavioral tendencies for not using sunscreen can help overcome this contributing risk factor for skin cancers. CONCLUSION: Future investigations have yet to identify confounding variables contributing to higher levels of skin cancers in this population.
ABSTRACT
OBJECTIVE: Routine male infant circumcision (RMIC) is a common procedure that inadvertently causes significant but preventable pain. In this best evidence review, we examine the available pain management options and their effectiveness for RMIC. MATERIAL AND METHODS: The Medline (OVID) and Cochrane library were searched for randomized controlled trials investigating pain control for RMIC. Only trials that included newborns younger than 45 days of age were included. The articles generated in the initial search were screened independently by two of the authors. A third reviewer settled any discrepancies about the inclusion. Then, trials were categorized based on the type of intervention: topical anesthetics, oral sucrose, oral acetaminophen, nerve blocks, caudal blocks, circumcision device, non-pharmacological adjuncts, and multiple combinations. RESULTS: Twenty-nine randomized clinical trials (RCTs) were found to address pain preventative measures in RMIC. As single agent, nerve blocks outperformed topical anesthetics and oral sucrose, as the latter two proved to be insufficient for proper pain control. Additionally, dorsal penile nerve block and ring blocks have a reasonable safety profile. The use of caudal blocks in RMIC was uncommon. Oral sucrose in association with swaddling or music are helpful and can be easily combined with other methods of pain management. Moreover, oral acetaminophen given perioperatively helps the patient recover. Ultimately, pain control should rely on a combination of anesthetics, analgesics, and kinesthetic methods to be administered before, during, and after the procedure for optimal outcome. CONCLUSION: RMIC is a painful procedure in need of proper pain control. Different interventions and agents have various abilities in controlling pain; however, developing a protocol centered around multimodal pain control proves to be the most effective.
