Post-traumatic stress symptoms experienced by healthcare workers in Lebanon four months following Beirut's ammonium nitrate explosion: a survey-based study.

BACKGROUND: On August 4, 2020, Lebanon faced one of the deadliest mass casualty explosions the world has witnessed during the twenty-first century. The human and emotional tolls were heavy on attending physicians, clinical fellows, residents, interns, medical students, and registered nurses, who were working in dramatic conditions, triaging, and treating thousands of blast-related casualties. We evaluated the risk of developing post-traumatic stress disorder symptoms (PTSS), among these healthcare workers (HCWs) from different Lebanese hospitals. METHODS: This is a multicentered, cross-sectional study that was conducted in December 2020, using an online questionnaire that evaluated the risk of developing PTSS based on the validated self-reported PTSD-Checklist for DSM-V (PCL-5). We also explored possible correlates with the participants' socio-demographic characteristics, job profile, mental health, and blast-related events. RESULTS: Out of 519 participants, 44% were at high risk of developing PTSS following Beirut-blast. Nurses, attending physicians, fellows, and participants who are older in age, married, or working at specific hospitals, were at a higher risk. Those identified at higher risk of PTSS were surgeons, anesthesiologists, emergency medicine doctors, or radiologists; and they were more likely to be willing to migrate; having a prior history of psychiatric medication intake for PTSD treatment, a prior history of PTSD, or a personal history of seeking mental health service. At last, the latter two parameters as well as the number of examined injuries, severe home damage, and testing positive for the COVID-19 virus during the two weeks' period that followed the blast were found to be predictors for the development of PTSS. CONCLUSION: Lebanese in-hospital HCWs were found to be at a high risk of developing PTSS following the Beirut-Blast, thus we recommend public health authorities to provide adequate resources to avoid the emergence of mental illnesses among these rescuers.

Resection of Hibernoma of the Proximal Shin Followed by Foot Drop and Tendon Transfer: A Case Report.

This is the description of the case of a 42-year-old male who presented with a growing, painless lump on his anterior leg. The diagnosis of a rare tumor called hibernoma was suspected after inspection of the radiologic findings. The unusual location of the tumor resulted in superficial peroneal nerve entrapment. The tumor was excised and the diagnosis of hibernoma was confirmed by histopathology. Surgery resulted in foot drop that was successfully treated with a tibialis posterior tendon transfer. Our case illustrates a rare tumor in an unusual location that can be challenging for clinicians to discern and to properly treat.

Relevance of proton pump inhibitors prescriptions in a tertiary care hospital in Lebanon.

BACKGROUND AND STUDY AIMS: Studies have shown that PPIs are frequently used in an inappropriate way, above the standard doses, and against the recommendations, leading to adverse events like malabsorption problems, community acquired pneumonia, hip fractures and Clostridium difficile colitis. In Lebanon only one study about the out-patient use of PPI was done in community pharmacies, but in-patient prescription studies are inexistent. Our study will evaluate the use of PPIs in a hospital setting in Lebanon and will compare it to international recommendations. PATIENTS AND METHODS: A cross-sectional study, conducted in a university hospital in Lebanon (CHU NDS) between June and November 2018, included 186 randomly selected Lebanese inpatient adults. RESULTS: Less than half of the participants (46.8%) received a PPI for the adequate indication and 83.9% received the adequate PPI molecule, whereas only 9.2% received the adequate dose. The rate of PPI misuse was higher in the surgery ward (59.6%) than in the medicine department (40.4%) (Cardiology, internal medicine, neurology, pneumology, nephrology, infectious diseases, gastro-enterology, rheumatology). Concerning age, 56.3% of the ≥ 65 years old patients were taking PPI for the right indication. However, among those who are < 65 years old, only 43.7% of the prescriptions were recommended. Also adequate PPI indication and adequate choice of drug was mainly noticed in patients having GI history or taking antiplatelet therapy. CONCLUSION: Our study has shown that a significant amount of PPIs was prescribed inadequately leading to a need to re-evaluate or adjust the use of PPIs among Lebanese physicians.