Knowledge and Attitude Among Lebanese Women Toward Hazardous Chemicals Used in Nail Cosmetics.

Middle Eastern women seek frequently for self-adornment. Harmful effects of chemicals used in nail care services have involved women worldwide. This study was performed to determine Lebanese women's knowledge and attitudes toward adverse effects of compounds used in nail cosmetics. A national cross-sectional study was carried out using an online questionnaire and targeting women in Lebanon. Data was collected on sociodemographic characteristics, nail cosmetics' application, preventive measures, perceived knowledge and self-reported side effects associated with nail cosmetic's use. A total cumulative knowledge score was calculated to categorize consumer knowledge. A total of 573 women completed the survey. Young women with a high school education or beyond were overrepresented. Most of the participants preferred applying classic manicure and removers on a weekly basis. Over 82% had poor/fair knowledge about health hazards associated with chemical compounds used in nail cosmetics with their levels of education acting as a key factor. Skin and neurological symptoms were the more frequently self-reported symptoms. Interestingly, the use of a nail hardener was linked to a higher prevalence of headache, nausea, allergy, skin irritation, itching and burn. The prevalence of the three later symptoms was higher among gel users. Moreover, few participants read nail cosmetics' labels or questioned their safety. Although nail cosmetics' application was common among Lebanese women, there is poor knowledge regarding their harmful effects. Based on these findings, it is warranted to launch health awareness campaigns and introduce a cosmetovigilance system to ensure the safety of the consumer products.

Antidiabetic medications in patients with heart failure.

Diabetes mellitus increases the mortality secondary to heart failure independent of hypertension and coronary artery disease. Several hypoglycemic agents are used to achieve glycemic control, of which several classes however still raise controversies in terms of safety in patients with concomitant heart failure: Metformin does not carry an increased risk of exacerbation in patients with stable heart failure, yet should be avoided in patients with unstable disease or chronic kidney disease. Sulfonylureas are neither associated with an increased mortality, nor do they seem to have deleterious effects on heart failure. Thiazolidinediones are relatively contraindicated in patients with New York Heart Association class III or IV disease secondary to concerns of fluid retention and heart failure exacerbation. Glucagon-like peptide 1 agonists have shown trends towards improvement of heart failure parameters. Dipeptidylpeptidase 4 inhibitors show an overall neutral outcome, although saxagliptin can possibly be associated with an increased risk of hospitalization for heart failure. The use of sodium-glucose co-transporter 2 inhibitors is associated with beneficial cardiovascular outcomes, and further studies are underway.