Purified protein derivative (PPD) conversion rate among Lebanese children in Beirut.

To determine the purified protein derivative conversion rate among Lebanese children we followed a cohort of 1236 students, ages 5-14 years, enrolled in 25 public schools in Beirut. All cases received an intradermal injection of purified protein derivative in 1992 and one year later. Test administration was done using standard techniques and results were read by the same physician 48-72 hours later. Demographic information was also obtained on the enrolled students. The majority of children identified belonged to a low socioeconomic class. The one year conversion rate was 1.4%. This underscores the urgent need for preventive programs.

House calls in Lebanon: reflections on personal experience.

BACKGROUND: Home health services play an important role in decreasing hospital admissions and physicians' medical house calls play an integral role in home health services. There is no national survey of physicians' house call practice in the Lebanon. OBJECTIVES: The aim of this study was to provide some information about house call practice in the Lebanon. METHOD: Data on patients examined during house call visits between 1 January and the end of December 1995 were reviewed. RESULTS: During this period, 137 patients were seen at their home. Eighty-four patients (62%) were female and 53 patients (38%) were male. Ages ranged from 1 to 85 years. The number of cases seen in 1 month averaged 11. The diagnosis differed according to the age group of patients examined. Most of the house call visits occurred between 6.30 p.m. to 12.00 p.m. (47%). Fifteen patients (11%) were admitted to the hospital. CONCLUSION: The rate of cases per month was similar to those reported elsewhere. Physicians might feel reluctant to conduct house calls out of hours. Our study revealed that the majority of patients were seen between 6 p.m. and 12 p.m., and only 6% were seen after 12 a.m. It is our belief that house calls are an integral part of family practice and need to be stressed during the internships of all primary care physicians.

Data from a public school health project in Beirut.

The health status of 2778 elementary students enrolled in twenty-five government schools in Beirut was evaluated. Parents completed special forms relating to demographic information, socioeconomic status, the students' medical and vaccination history, and the presence of certain medical conditions in the family. A complete physical examination of each student was carried out. Seventy-six percent of the children belonged to families with a monthly income between US $118-237. The most common medical problems encountered were poor dentition (53%), incomplete immunization (22-63%) for the various vaccines, enuresis (9%), pediculosis (8%), and defective vision (6%). It was also noticed that 72% of the students have at least one member in the family who smokes. The data presented in this study show the need for fluoridation of public water; provision of accessible and affordable medical and dental care; carrying vaccination campaigns and introducing health education in elementary schools in Lebanon.

The value of chest X ray in asymptomatic young adults with positive PPD test.

The value of chest radiograph in the management of asymptomatic tuberculin positive (> 10mm) individuals is controversial. We reviewed the results from two centers in Beirut: The Employment Health Program at Makassed General Hospital (MGH) in 1984 and the Visa Applicants Program at the American University of Beirut Medical Center (AUB-MC) 1990-1991. All subjects were free of symptoms and their physical examination was unrevealing. At MGH, out of 450 PPD tests, 46 (10.2%) were positive and chest-x-rayed. Forty-four (95.6%) were reported as normal, one had a chronic inflammation and one had metastasis. At AUB-MC, 67 PPD positive persons were x-rayed, of whom 65 (97%) were normal and the remainder two showed inactive granulomatous disease. No active tuberculosis case was detected. Isoniazid (INH) prophylaxis is recommended in the above selected group of subjects. We conclude that routine chest radiograph is of no significant value in the management of asymptomatic positive skin reactors, age group (16-35). A larger study is being undertaken for further delineating the usefulness, as well as the cost effectiveness of routine chest X ray being done on the above mentioned groups of individuals in our population.

Sacral osteoid osteoma in a 10 year old girl.

We report the case of a ten year old female student who complained of chronic back pain and morning stiffness of several months duration. She failed to respond to non-steroidal anti-inflammatory drugs (NSAIDS). Further investigations which included bone and CT scan revealed the presence of an osteoid osteoma at the first sacral vertebra (S1 vertebra). The patient made an excellent recovery after surgical excision.

Cytoskeletal control of alanine transport across the rat and turtle small intestine.

Procaine inhibited significantly (P less than 0.01) alanine accumulation in the rat intestinal strips in a concentration-dependent pattern, whereas it showed no effect on alanine uptake by the turtle intestinal cells. Colchicine and Vinca alkaloids at 5 X 10(-4) and 1.5 X 10(-6) M respectively caused a significant inhibition (P less than 0.01) of intracellular alanine concentration in the rat with no effect noticed in the turtle. Unidirectional influx of alanine across the brush border membrane of the rat was significantly (P less than 0.01) reduced in the presence of procaine, colchicine and vincristine in the preincubation medium. The same drugs did not show any effect on alanine influx into the turtle small intestine. Electron microscopy showed major structural alterations in the cytoskeletal organization of the turtle intestine in response to procaine, colchicine or vincristine treatment. It is proposed that microtubular system may participate in the overall transport mechanism of alanine across the small intestine.