Urinary schistosomiasis(bilharziasis), caused by digenetic bloodfluke, is an endemic disease in Africa, Yemen, Saudi Arabia, Israel, Lebanon, Syria and Iran, but not in Korea. We report one case of urinary schistosomiasis in Korea, who worked in North Yemen, with the review of literatures.
Africa ; Endemic Diseases ; Iran ; Israel ; Korea ; Lebanon ; Saudi Arabia ; Schistosomiasis ; Schistosomiasis haematobia* ; Syria ; Yemen

PURPOSE: Computational flow dynamic (CFD) study has not been widely applied in intracranial artery stenosis due to requirement of high resolution in identifying the small intracranial artery. We described a process in CFD study applied to symptomatic severe intracranial (M1) stenosis before and after stenting. MATERIALS AND METHODS: Reconstructed 3D angiography in STL format was transferred to Magics (Materialise NV, Leuven, Belgium) for smoothing of vessel surface and trimming of branch vessels and to HyperMesh (Altair Engineering Inc., Auckland, New Zealand) for generating tetra volume mesh from triangular surface-meshed 3D angiogram. Computational analysis of blood flow in the blood vessels was performed using the commercial finite element software ADINA Ver 8.5 (ADINA R & D, Inc., Lebanon, MA). The distribution of wall shear stress (WSS), peak velocity and pressure in a patient was analyzed before and after intracranial stenting. RESULTS: Computer simulation of wall shear stress, flow velocity and wall pressure before and after stenting could be demonstrated three dimensionally by video mode according to flow vs. time dimension. Such flow model was well correlated with angiographic finding related to maximum degree of stenosis. Change of WSS, peak velocity and pressure at the severe stenosis was demonstrated before and after stenting. There was no WSS after stenting in case without residual stenosis. CONCLUSION: Our study revealed that CFD analysis before and after intracranial stenting was feasible despite of limited vessel wall dimension and could reveal change of WSS as well as flow velocity and wall pressure.
Angiography ; Arteries ; Atherosclerosis ; Blood Vessels ; Cerebral Arteries ; Characidae ; Computer Simulation ; Constriction, Pathologic ; Glycosaminoglycans ; Humans ; Lebanon ; Magic ; Stents

The nationwide epidemiological study of mental disorders including suicide ideation and suicide attempts in Korea using DIS-III Korean Version was conducted in the Capital City of Korea(Seoul) and 20 rural areas and compared to the other 8 countries. The results were as follows : 1) The lifetime prevalence of suicide ideation were 18.51% in New zealand, 15.62% in Munich, Germany, 14.20% in France, 11.25% in Canada, 11.18% in the USA, 9.5% in Puerto Rico, 5.28% in Taiwan and 2.09% in Lebanon, respectively 2) The lifetime prevalence of suicide ideation was higher in female than male Divorced and separated persons were at the highest risk and next were never married. Married persons were at the lowest risk. 3) The lifetime prevalence of suicide attempts were 5.93% in Puerto Rico, 4.95% in France, 4.43% in New Zealand, 3.82% in Canada, 3.44% in Munich Germany, 3.20% in Korea, 3.13% in the USA, 0.75% in Taiwan and 0.72% in Lebanon, respectively. 4) The lifetime prevalence of suicide attempts were highest in female and divorced or separated. Next were never married and lowest were married.
Canada ; Divorce ; Epidemiologic Studies* ; Epidemiology ; Female ; France ; Germany ; Humans ; Korea* ; Lebanon ; Male ; Mental Disorders* ; New Zealand ; Prevalence ; Puerto Rico ; Single Person ; Spouses ; Suicide* ; Taiwan

This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake (58.86%+/- 33.87% of needs) yet adequate dietary P intake (795.52 +/- 366.94 mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.
Chelating Agents ; Developing Countries ; Dialysis ; Diet ; Education* ; Humans ; Kidney Diseases ; Lebanon* ; Malnutrition ; Nutrition Policy ; Nutritional Status ; Nutritionists ; Quality of Life ; Renal Dialysis ; Renal Osteodystrophy

BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: 38.75 +/- 17.20%, post: 62.08 +/- 21.85%). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.
Body Weight ; Delivery of Health Care ; Dietetics ; Education, Continuing* ; Evidence-Based Practice ; Humans ; Lebanon ; Nutritionists ; Patient Compliance ; Phosphorus ; Renal Dialysis ; Research Personnel

PURPOSE: Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. METHODS: We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. RESULTS: Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). CONCLUSION: Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.
Adenoviridae ; Amebiasis ; Child ; Child, Hospitalized* ; Diagnosis ; Diarrhea ; Entamoeba histolytica ; Gastroenteritis* ; Hospitalization ; Humans ; Hygiene ; Incidence ; Lebanon* ; Male ; Prevalence ; Prospective Studies ; Refugees ; Rotavirus ; Tertiary Healthcare ; Water ; Water Supply