Substance use disorder in the context of the economic crisis, covid-19 pandemic and social unrest: a cross-sectional study across Beirut (2020-2021).

BACKGROUND: Substance use disorder (SUD) is related to the interplay of various factors. The primary objective of this study was to assess the variation in substance use (SU) among a set of Lebanese people undergoing treatment for SUD during the Lebanese economic crisis, COVID-19 pandemic, and Beirut Blast. METHODS: A cross-sectional study including Lebanese adults previously diagnosed with and being treated for SUD at the Skoun center was conducted. Data collection was done using a paper-based Arabic questionnaire tackling the economic crisis, the Covid-19 pandemic, and the Beirut Blast, as well as the following scores: APGAR, PHQ-9, GAD-7 and PCL-6. Data were analyzed using SPSS version 25.0 with P value<0.05 considered significant. A bivariate analysis was conducted to study the association between the use of substances and study variables and scores. RESULTS: The sample included 126 men and 10 women. Most participants had a stable consumption of illicit drugs (58.8%), alcohol (76.5%), prescription drugs (70.6%) and non-prescription drugs (89%). Additionally, most participants had concomitant mild or moderate depression (55.1%), mild or moderate anxiety (50.7%), and PTSD (61.8%). Factors found to significantly increase SU were economic distress, change in employment status, and decrease in working hours. PTSD was also identified as a risk factor for increased illicit drug and alcohol use. Furthermore, severe anxiety was found to be a risk factor for increased alcohol consumption. CONCLUSION: Most participants were able to maintain a stable pattern of SU despite the quadruple crisis in Lebanon highlighting the important role played by Lebanese Non-Governmental Organizations (NGOs) and efforts employed to control SUD.

Current landscape of clinical trials for HPV-positive head and neck squamous cell carcinoma (HNSCC).

This study aims to determine the current state of clinical trials regarding HPV-positive head and neck squamous cell carcinoma (HNSCC). Clinical trials were filtered to fit the study's aim using Clinicaltrials.gov: trials concerning HNSCC specifically those related to HPV done between January 2005 and December 2020 were extracted and information regarding location, duration, phases, patient recruitment, trial status, results, primary outcome, type of intervention and publication status were collected and analysed. As a result, 123 trials were included. North American countries (USA and Canada) conducted more than two-thirds of the trials (72.4%) compared to European countries and the rest of the world. Trials in phase II constituted more than half of those included in this study (53.7%). From the 123 trials included in this study, only 30 had their NCT identification number linked to publications, but less than half (46.7%) of the publications stemmed from trials with results. Drug combination was the most widely studied treatment modality. Despite falling in the middle of the spectrum with respect to the number of trials when compared to other diseases, our research highlights the need for even more trials tackling multiple aspects of HPV-positive HNSCC.

Our Experience With Transduodenal Surgical Ampullectomy.

Tumors of the ampulla of Vater are uncommon lesions accounting for only 0.5% of the gastrointestinal tumors. A total of three techniques for ampullary tumors (AT) exist: endoscopic papillectomy (EP), surgical transduodenal ampullectomy (TDA), and partial pancreatoduodenectomy (PD). Scarce articles report the outcomes of TDA. Two Arabic men presented to the hospital with epigastric pain and were subsequently diagnosed with AT. The TDA was performed a few days after the diagnosis. The first patient underwent a partial gastrectomy on the eleventh postoperative day. The second patient underwent endoscopic pyloric re-opening on the eleventh postoperative day to relieve gastric obstruction. Both patients started tolerating food and were discharged home. Further randomized controlled studies assessing long-term complications, efficacy, and efficiency of TDA are now warranted.

Epidemiology and Incidence of Retinoblastoma in the Middle East: A Nationwide Study in Lebanon.

BACKGROUND: Retinoblastoma, although a rare pediatric cancer, can lead to disastrous outcomes if not managed early. This mishap often happens in developing countries. Conversely, early diagnosis and treatment of retinoblastoma in developed countries were associated with a surge in RB1 gene carriers. AIM: The authors aimed to evaluate the incidence of retinoblastoma in the Lebanese population aged between 0 and 19 years according to age, sex, and other variables and compare the age-standardized incidence rates with regional and worldwide countries. METHODS: Data were retrieved from the National Cancer Registry (NCR) of the Ministry of Public Health (MOPH). Subsequently, incidence rates, age-standardized rates, and fictional incidence rates excluding the emigrant population were calculated. Retinoblastoma trends were found using the Joinpoint regression program software. RESULTS: From the 38 cases of retinoblastoma recorded in the nine years cohort, 29 cases occurred in the 0-4 age group, and age-standardized rates were 2.8 and 3.6 per million person-years for the 0-19 and 0-14 age groups, respectively. When the refugee population was excluded, the ASR 0-19 almost doubled from 2.8 per million person-years to 5.16 per million person-years. Joinpoint regression revealed that retinoblastoma trends were divided into two segments showing a decrease from 2005 until 2011 and a rising trend in 2011-2015. When compared to other countries in the region, Lebanon had low-intermediate 0-19 ASRs. CONCLUSION: Retinoblastoma incidence in Lebanon is in the lower margin of the worldwide average and could be underestimated due to the underdiagnosis in the refugee population. Efforts are being deployed to overcome the financial barriers in the treatment of retinoblastoma by coordinating with neighboring Arab countries.

Attitudes Towards Psychiatry in Lebanese Medical Students: What Are the Factors that Could Lead to a More Favorable Outlook?

OBJECTIVE: The authors aimed to assess the attitudes towards psychiatry of all Lebanese medical students, as well as the factors that could have led to these attitudes, whether favorable or not. METHODS: In this cross-sectional study, the authors ran a questionnaire among a sample of Lebanese medical students from all medical faculties, regions in Lebanon, and years of medical school, using the ATP-30 scale and the WHO-5 well-being index. The answers from the 607 participants were statistically analyzed on SPSS version 23.0. RESULTS: Among participants, 95.1% had a positive attitude towards psychiatry, reflecting a favorable outlook among Lebanese medical students overall. The average ATP-30 score in our sample was 111.95 out of 150 (SD = 12.55), which is in the range of countries of higher socio-economic level such as Germany and Switzerland. Also, 26.5% of participants reported that they consider psychiatry as a potential career choice. No demographic factor had any influence on the ATP-30 score. In the multivariate analysis, only two factors resulted in favorable attitudes: exposure to a patient with a diagnosed psychiatric illness in the student's surroundings and a lower WHO-5 well-being index. CONCLUSION: This study's results do not fit into the traditional "developed vs. developing countries" paradigm. However, Lebanon still has a lot of challenges to face in order to provide quality mental healthcare.

Psoriasis: A bibliometric analysis in the Arab World (2004-2019).

BACKGROUND: Psoriasis is a relatively common inflammatory skin disease with systemic implications. Psoriasis data seem to arise from a select number of countries, while other areas in the world with different genetics and ethnicities, especially Arab countries have a questionable input. AIM: This study aims to quantitatively assess Arab countries contributions in psoriasis research. METHODS: The number of publications related to psoriasis for each of the 22 Arab countries was found on PubMed for every year between 2004 and 2019, and then, the total for each country was normalised according to three parameters: average population, Gross Domestic Product and psoriasis disability-adjusted life years. In addition, the number of psoriasis articles was also retrieved for 2 other groups: South America and Far East Asia, for comparison. RESULTS: Only 1.53% of all psoriasis research published between 2004 and 2019 originates from Arab countries (vs. 2.06% from South American countries and 13.2% from Far East Asian countries), and psoriasis articles make up only 0.15% of the total publications from Arab countries (vs. 0.10% for both South American and Far East Asian countries). Egypt scored the highest number of psoriasis-related articles and accounted on its own for almost half the number of psoriasis publications (47.9%) from Arab countries. When normalised according to the 3 parameters, other Arab countries also rose to prominence; Kuwait had the highest number of publications per million persons, and Tunisia had the highest number of publications per GDP. However, Egypt ranked once again first as having the highest number of publications per 1% psoriasis-related DALY. Among the three parameters, the average population size proved to be the most strongly correlated with the number of psoriasis publications in a given country. CONCLUSION: There is an incontestable need for more research related to psoriasis in Arab countries as the numbers are still very low reflecting many difficulties standing In the way of research in general in the Arab world.