scholarly journals Five-Year Incidence and Progression of Diabetic Retinopathy in Patients with Type II Diabetes in a Tertiary Care Center in Lebanon

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Carl-Joe Mehanna ◽  
Maamoun Abdul Fattah ◽  
Hani Tamim ◽  
Mona P. Nasrallah ◽  
Raya Zreik ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Type Ii Diabetes ◽  
Medical Center ◽  
Statistical Significance ◽  
Care Center ◽  
Tertiary Care ◽  
Progression Rate ◽  
Type Ii ◽  
American University ◽  
American University Of Beirut

Objective. To estimate the 5-year incidence of progression rate and regression rate and risk factors for diabetic retinopathy (DR) in a cohort of Lebanese patients with type II diabetes. Methods. We followed a cohort of 462 Lebanese patients with type II diabetes for over 5 years at the American University of Beirut Medical Center. Patients underwent yearly complete ophthalmic evaluation and fundus photographs and were assessed for the incidence, stage, and evolution of DR using modified Airlie House classification. Results. Among the 462 patients, 281 had no DR at baseline. The 5-year cumulative incidence of any DR was 10% (95% CI: 6–13), and only baseline microalbuminuria correlated with the development of DR (OR=10.53, 95% CI: 4.39–25.23, p<0.0001). Among the 181 patients with baseline DR, the worsening and regression rates of DR were 31.5% (95% CI: 25–38) and 9% (95% CI: 5–13), respectively. Microalbuminuria also approached statistical significance as a risk factor for DR worsening (OR=1.89, 95% CI: 0.97–3.70, p=0.06). Conclusion. The 5-year incidence of DR in this hospital-based cohort is relatively low. Microalbuminuria was independently associated with the incidence and progression of the disease. We recommend to screen patients with type II diabetes for microalbuminuria as prognostic for the development and worsening of DR.

scholarly journals First Candida auris Outbreak during a COVID-19 Pandemic in a Tertiary-Care Center in Lebanon

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 157
Author(s):  
Fatima Allaw ◽  
Nada Kara Zahreddine ◽  
Ahmad Ibrahim ◽  
Joseph Tannous ◽  
Hussein Taleb ◽  
...  
Keyword(s):  
Infection Control ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Arab Countries ◽  
Infection Prevention And Control ◽  
Tertiary Care Center ◽  
Candida Auris ◽  
American University ◽  
American University Of Beirut

Candida auris is an emerging fungal pathogen considered as a global health threat. Recently there has been growing concern regarding drug resistance, difficulty in identification, as well as problems with eradication. Although outbreaks have been reported throughout the globe including from several Arab countries, there were no previous reports from Lebanon. We herein report the first cases of C. auris infection from the American University of Beirut Medical Center, a tertiary care center in Lebanon describing the clinical features of the affected patients in addition to the infection control investigation and applied interventions to control the outbreak. Fourteen patients with C. auris infection/colonization identified using MALDI-TOF and VITEK 2- Compact system were reported over a period of 13 weeks. Patients were admitted to four separate critical care units. All of them came through the emergency room and had comorbid conditions. Half of the patients were infected with COVID-19 prior to isolation of the C. auris. C. auris was isolated from blood (two isolates), urine (three isolates), respiratory tract (10 isolates) and skin (one isolate). All the patients had received broad spectrum antibiotics prior to isolation of C. auris. Six patients received antifungal treatment, while the remaining eight patients were considered colonized. Environmental cultures were taken from all four units and failed to isolate the organism from any cultured surfaces. A series of interventions were initiated by the Infection Prevention and Control team to contain the outbreak. Rapid detection and reporting of cases are essential to prevent further hospital transmission. A national standardized infection control registry needs to be established to identify widespread colonization.

scholarly journals Corrigendum to “Five-Year Incidence and Progression of Diabetic Retinopathy in Patients with Type II Diabetes in a Tertiary Care Center in Lebanon”

2018 ◽  
Vol 2018 ◽  
pp. 1-1
Author(s):  
Carl-Joe Mehanna ◽  
Maamoun Abdul Fattah ◽  
Hani Tamim ◽  
Mona P. Nasrallah ◽  
Raya Zreik ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Type Ii Diabetes ◽  
Care Center ◽  
Tertiary Care ◽  
Type Ii ◽  
Tertiary Care Center

Clinical and Microbiological Profile of Urinary Tract Infection at a Tertiary-Care Center in Lebanon

2004 ◽  
Vol 25 (1) ◽  
pp. 82-85 ◽  
Author(s):  
Roula Fadel ◽  
Ghenwa K. Dakdouki ◽  
Zeina A. Kanafani ◽  
George F. Araj ◽  
Souha S. Kanj
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
American University ◽  
E Coli ◽  
American University Of Beirut ◽  
Hospital Acquired

AbstractWe compared community-acquired urinary tract infection (UTI) with hospital-acquired UTI at the American University of Beirut Medical Center. Escherichia coli was the most frequently isolated organism. Hospital-acquired E. coli isolates were often rnultidrug resistant. These results can be used to improve empiric treatment of UTI.

scholarly journals Physicians’ approach to end of life care: comparison of two tertiary care university hospitals in Lebanon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Dabar ◽  
Imad Bou Akl ◽  
Mirella Sader
Keyword(s):  
End Of Life ◽  
Medical Center ◽  
Tertiary Care ◽  
Medical Culture ◽  
University Hospitals ◽  
American University ◽  
American University Of Beirut ◽  
European Training ◽  
Eol Care ◽  
Attending Physicians

Abstract Background The care of terminally ill patients is fraught with ethical and medical dilemmas carried by healthcare professionals. The present study aims to explore the approaches of Lebanese attending physicians towards palliative care, end of life (EOL) care, and patient management in two tertiary care university hospitals with distinct medical culture. Methods Four hundred attending physicians from the American University of Beirut Medical Center (AUBMC) and Hotel Dieu de France (HDF) were recruited. Participants were Medical Doctors in direct contact with adult patients that could be subject to EOL situations providing relevant demographic, educational, religious as well as personal, medical or patient-centric data. Results The majority of physicians in both establishments were previously exposed to life-limiting decisions but remains uncomfortable with the decision to stop or limit resuscitation. However, physicians with an American training (AUBMC) were significantly more likely to exhibit readiness to initiate and discuss DNR with patients (p<0.0001). While the paternalistic medicinal approach was prevalent in both groups, physicians with a European training (HDF) more often excluded patient involvement based on family preference (p<0.0001) or to spare them from a traumatic situation (p=0.003). The majority of respondents reported that previous directives from the patient were fundamental to life-limiting decisions. However, the influence of patient and medical factors (e.g. culture, religion, life expectancy, age, socioeconomic status) was evidenced in the HDF group. Conclusion Early physician-initiated EOL discussions remain challenged in Lebanon. Paternalistic attitudes limit shared decision making and are most evident in European-trained physicians. Establishing a sound and effective framework providing legal, ethical and religious guidance is thus needed in Lebanon.

scholarly journals Candida profiles and antifungal resistance evolution over a decade in Lebanon

2015 ◽  
Vol 9 (09) ◽  
pp. 997-1003 ◽  
Author(s):  
George Farah Araj ◽  
Rima George Asmar ◽  
Aline Zakaria Avedissian
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Antifungal Resistance ◽  
Candida Spp ◽  
American University ◽  
Antifungal Drug Resistance ◽  
Resistance Evolution

Introduction: Infection with and antifungal resistance of Candida species have been on the rise globally. Relevant data on these pathogens are relatively few in our region, including Lebanon, thus warranting this study. Methodology: This retrospective study of Candida spp. profiles and their in vitro antifungal susceptibility was based on analysis requests for 186 Candida non-albicans and 61 C. albicans during three periods (2005–2007, 2009–2011, and 2012–2014) over the span of the last 10 years at the American University of Beirut Medical Center (AUBMC), a major tertiary care center in Lebanon. Identification of Candida was done using the API 20C AUX system, and the E-test was used to determine the minimum inhibitory concentrations (MICs) of antifungal agents. Results: Among the 1,300–1,500 Candida isolates recovered yearly, C. albicans rates decreased from 86% in 2005 to around 60% in 2014. Simultaneously, the non-albicans rates increased from 14% in 2005 to around 40% in 2014, revealing 11 species, the most frequent of which were C. tropicalis, C. glabrata, and C. parapsilosis. All these demonstrated high resistance (35%–79%) against itraconazole, but remained uniformly susceptible (100%) to amphotericin B. Though C. albicans and the other species maintained high susceptibility against fluconazole and voriconazole, their MIC90 showed an elevated trend over time, and C. glabrata had the highest resistance rates. Conclusions: The observed rise in resistance among Candida spp. in Lebanon mandates the need for close surveillance and monitoring of antifungal drug resistance for both epidemiologic and treatment purposes.

scholarly journals Mean Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Attending Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1243-1246
Author(s):  
Prakash Kayastha ◽  
Sharma Paudel ◽  
Ghanshyam Gurung ◽  
Pradeep Kumar ◽  
Rudra Prasad Upadhyaya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Care Center ◽  
Tertiary Care ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type Ii ◽  
Media Thickness

Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an important tool for estimating the risk of cardiovascular and cerebrovascular events. It is a simple, noninvasive and widely available tool which can give idea of further treatment needed. The objective of this study was to determine the mean intima media complex thickness in patients with type II diabetes mellitus attending a tertiary care center. Methods: This was a descriptive cross-sectional study done in 64 patients with the type II diabetes mellitus patients visiting diabetic clinic of Tribhuvan University Teaching Hospital, sent for carotid Doppler examination in the department of radiology and imaging. Ethical approval was taken from the Instituitonal Review Board. Convenient sampling method was used. Carotid intima media thickness was measured on both sides and mean intima media thickness was calculated. Mean intima media thickness for male and female diabetic patients was also calculated separately. Statistical Package for Social Sciences version 25 was used for data analysis. Results: The mean carotid intima media thickness was 0.86±0.13mm with range from 0.7mm to 1.3mm. Mean intima media thickness in male was 0.832±0.094mm and in female it was 0.904±0.144mm. Among 64 patients, 30 (46.8%) were female and 34 (53.3%) were male. Age of the patients ranged from 35 years to 68 years with mean age of 52.4±6.54 years. Conclusions: Carotid intima media thickness in patients with type II diabetes mellitus showed higher values than that of mean value from study done in similar study. Female had higher mean intima media thickness than male.

scholarly journals Prevalence of Type II Diabetes Mellitus Among Adult Population in Medical Department of A Tertiary Care Centre

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Lochan Karki ◽  
Krishna Rana ◽  
Manisha Shahi ◽  
Anjila Pradhan ◽  
Roshina Thapa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Care Center ◽  
Adult Population ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Ethical Review ◽  
Type Ii ◽  
Tertiary Care Center ◽  
Medical Department

Introduction: Diabetes mellitus is a chronic metabolic disease that is mainly associated with a number of lifestyle behaviors. There is a high discrepancy among urban and rural populations with the prevalence of diabetes in rural areas as 2.5% and a high prevalence of 14.6% in urban areas. Type 2 diabetes mellitus accounts for the majority of all diabetes cases with a number of chronic effects that include cardiovascular disease, kidney disease, blindness, and disability. This study is done to determine the prevalence of Type II Diabetes Mellitus among the adult population in the medical department of a tertiary care center. Methods: A descriptive cross-sectional study was done in a medical department of a tertiary care center of Himal Hospital Private Limited from March to April 2020. Ethical approval was taken from the Ethical Review Board of NHRC (Reference Number 752). All the data of the last two years from the medical record section were included in the study. The convenience sampling technique was followed. Descriptive statistical analysis was done. Results: The study showed the prevalence of Type II Diabetes Mellitus among the adult population to be 23.93 % (0.23) (C.I= 0.20-0.26). Prevalence was found to be ... Conclusions: The prevalence of Type II Diabetes Mellitus was found to be higher than the previous study done in similar settings.

scholarly journals Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

2021 ◽  
pp. 1-26
Author(s):  
Akane Takamatsu ◽  
Hitoshi Honda ◽  
Tomoya Kojima ◽  
Kengo Murata ◽  
Hilary Babcock
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccination Rate ◽  
Multifaceted Intervention ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Tertiary Care Center ◽  
Post Intervention ◽  
Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

Radiology of terror injuries: the American University of Beirut Medical Center experience

2008 ◽  
Vol 32 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Maurice C. Haddad ◽  
Nabil J. Khoury ◽  
Mukbil H. Hourani
Keyword(s):  
Medical Center ◽  
American University ◽  
American University Of Beirut
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