Endoscopic Versus Open Carpal Tunnel Release: An Umbrella Review and a Meta-analysis.

INTRODUCTION: Whether endoscopic carpal tunnel release (ECTR) versus open carpal tunnel release (OCTR) has superior outcomes remains a controversial topic. Therefore, we sought to perform an umbrella review and meta-analysis to compare ECTR and OCTR with regards to (1) postoperative functional ability, (2) operative outcomes, and (3) time to return to work. METHODS: A PubMed, Scopus, and Cochrane database search was conducted for all meta-analyses comparing ECTR and OCTR performed between 2000 and 2022 in accordance to PRISMA and Joanna Briggs Institute guidance for umbrella reviews. The primary outcomes were as follows: (1) functional ability-symptoms severity, postoperative grip strength, postoperative pinch strength, 2-point discrimination, and pain; (2) operative outcomes-operation time, total complications, nerve injury, and scar-related complication; and (3) time to return to work. Quality was assessed using the Assessment of Multiple Systematic Reviews. Pooled analysis was performed to compare several clinical outcome measures between groups, depending on the availability of data using Review Manager Version 5.2.11. RESULTS: A total of 9 meta-analyses were included, 5 were of high quality and 4 were moderate quality. For functional ability, ECTR was associated with better pinch strength after 3 months (0.70, 95% confidence interval [CI] = 0.00, 1.40, P = 0.05) and 6 months (0.77, 95% CI = 0.14, 1.40, P = 0.02, I2 = 84%). For return to work, OCTR was associated with longer return to work compared with ECTR (-10.89, 95% CI = -15.14, -6.64, P < 0.00001, I2= 83%). There were no significant differences between OCTR and ECTR in the hand function, symptom severity, grip strength, pain, operation time, and total complications. CONCLUSIONS: In an umbrella review and meta-analysis of ECTR versus OCTR, ECTR was associated with a higher pinch strength, and a shorter time to return to work. Differences in major complications, such as nerve injury, were unclear due to statistical inconsistency and bias.

Mechanism of Action of Melatonin as a Potential Adjuvant Therapy in Inflammatory Bowel Disease and Colorectal Cancer.

Inflammatory bowel disease (IBD), a continuum of chronic inflammatory diseases, is tightly associated with immune system dysregulation and dysbiosis, leading to inflammation in the gastrointestinal tract (GIT) and multiple extraintestinal manifestations. The pathogenesis of IBD is not completely elucidated. However, it is associated with an increased risk of colorectal cancer (CRC), which is one of the most common gastrointestinal malignancies. In both IBD and CRC, a complex interplay occurs between the immune system and gut microbiota (GM), leading to the alteration in GM composition. Melatonin, a neuroendocrine hormone, was found to be involved with this interplay, especially since it is present in high amounts in the gut, leading to some protective effects. Actually, melatonin enhances the integrity of the intestinal mucosal barrier, regulates the immune response, alleviates inflammation, and attenuates oxidative stress. Thereby, the authors summarize the multifactorial interaction of melatonin with IBD and with CRC, focusing on new findings related to the mechanisms of action of this hormone, in addition to its documented positive outcomes on the treatment of these two pathologies and possible future perspectives to use melatonin as an adjuvant therapy.

Lack of Syndecan-1 promotes the pathogenesis of experimental rheumatoid arthritis.

Syndecan-1 (Sdc-1), a transmembrane heparan sulfate protein, is implicated in several pathophysiological processes including rheumatoid arthritis (RA). The exact role of Syndican-1 in this autoimmune disease is still undetermined. This study explores the involvement level of Sdc-1 in the development of RA in a collagen II-induced arthritis mice model. RA was induced in two mice strains (wild-type BALB/c group and Sdc-1 knockout) by collagen II. Mice underwent regular clinical observations and scoring. After sacrifice, leg biopsies were taken from mice for histological examination, using a variety of stains. In addition, proteins were extracted, and molecular assessment of TNF-α was performed using the western blot technique. In the Sdc-1 knockout group, clinical scoring results showed a significantly more severe experimental RA; histology showed a significant increase in bone erosion, cartilage destruction, inflammation, and less granulated mast cells than the wild-type. In addition, molecular assessment of TNF-α showed more increase in expression in the Sdc-1 knockout models compared to the wild-type. Data suggest that lack of Sdc-1 enhances the inflammatory characteristics in RA. However, more molecular studies and investigations are needed to determine its exact role and possible mechanisms involved.

Barriers toward xenotransplantation in Arab World.

Organ transplant is a crucial therapeutic strategy offering a life-saving and transformative medical intervention. It provides an opportunity to improve their quality of life and increase their lifespan. The shortage of organs remains a critical global challenge, leading to a prolonged waiting times for organ receivers, which contributes to an increase in morbidity and mortality rates. Hence, xenotransplantation offered a promising solution to the global shortage of organs through the use of animal organs, leading to an increase in donor availability, reducing waiting times, minimizing organ trafficking, improving genetic engineering advancements, and driving scientific innovation. Even though xenotransplantation has many benefits in the clinical setting, it has many barriers that are hindering its achievements and constraining its occurrence. Some barriers to xenotransplant are general, such as the immunological barrier, while others are specific to certain regions due to local causes. The Arab region exhibits disparities in clinical settings compared to the global context, marked by the huge economic crisis and a shortage of trained healthcare professionals. Considering the huge resources and advancements needed in the field of xenotransplantation, this review aims to explore the specific barriers toward xenotransplantation in the Arab countries, highlighting the challenges to overcome these barriers.

Examining the validity and reliability of the Arabic translated version of the depression and somatic symptoms scale (A-DSSS) among the Lebanese adults.

The prevalence of depression is high worldwide, and somatic symptoms are known to be one of the most debilitating aspects of depression. However, clinicians often face challenges in accurately assessing this comorbidity. To address this issue, the Depression and Somatic Symptoms Scale (DSSS) was developed as a self-administered scale that can diagnose both depression and somatic symptoms. The objective of this study is to evaluate the validity and reliability of the Arabic-translated version of the DSSS (A-DSSS) in a sample of Lebanese adults, as well as to explore its associated factors. A cross-sectional study was conducted over a period of one month, from February to March 2023, and involved a sample of 422 participants who were aged 18 years or older. Participants completed a questionnaire that included various measures, including demographic characteristics, alcohol and smoking habits, physical activity history, as well as two scales: the Patient Health Questionnaire-9 (PHQ9) scale and the A-DSSS scale. The A-DSSS showed high internal consistency (Cronbach's alpha = 0.936), strong test-retest reliability (ICC of 0.988 with CI 0.976-0.994; p < 0.001), and a three-factor structure consistent with previous research. Convergent validity was supported by a significant correlation with the PHQ-9. Stepwise linear regression revealed that engaging in physical activity and increasing calorie consumption (as measured by MET-min/week score) were associated with a significant decrease in the A-DSSS total score and subscales. However, a significant increase in the A-DSSS total score was seen in the female gender in comparison for male gender. The A-DSSS revealed good psychometric properties and may be a useful tool for assessing depression and somatic symptoms in this population. The study also identified potential factors associated with depression and somatic symptoms, such as physical activity, calorie consumption, and gender, which may have implications in addressing depression and somatic symptoms for future interventions and clinical practice.

Probiotics, gut microbiome, and cardiovascular diseases: An update.

Cardiovascular diseases (CVD) are one of the most challenging diseases and many factors have been demonstrated to affect their pathogenesis. One of the major factors that affect CVDs, especially atherosclerosis, is the gut microbiota (GM). Genetics play a key role in linking CVDs with GM, in addition to some environmental factors which can be either beneficial or harmful. The interplay between GM and CVDs is complex due to the numerous mechanisms through which microbial components and their metabolites can influence CVDs. Within this interplay, the immune system plays a major role, mainly based on the immunomodulatory effects of microbial dysbiosis and its resulting metabolites. The resulting modulation of chronic inflammatory processes was found to reduce the severity of CVDs and to maintain cardiovascular health. To better understand the specific roles of GM-related metabolites in this interplay, this review presents an updated perspective on gut metabolites related effects on the cardiovascular system, highlighting the possible benefits of probiotics in therapeutic strategies.

The Mechanism and Potential Therapeutic Effects of Cyclosporin, Cyclophilin, Probiotics and Syndecan-1 in an Animal Model of Inflammatory Bowel Disease.

Background: Inflammatory bowel diseases (IBDs) have several treatment modalities including immunoregulators, like cyclosporine A, an immunosuppressant that interacts with cytoplasmic cyclophilin A, and probiotics. Aims: This study explored and compared the possible role of syndecan-1 in the IBD pathogenic process as well as the effectiveness of cyclophilin A, cyclosporine A, and their combination in the management of IBDs in the presence of probiotics. Methodology: IBD was induced in a total of 112 mice equally divided between syndecan-1 knock-out (KO) and Balb/c wild-type mice, using 2% dextran sulfate sodium (DSS) followed by intraperitoneal treatment with cyclosporine A, cyclophilin A, or a combination of both. In addition, a daily dose of probiotics was given in their drinking water. The animals were monitored for clinical signs and symptoms and checked for gross pathologies in the abdomen after 3 weeks. Descending and sigmoid colon biopsies were collected and fixed for routine microscopy or frozen for protein extraction and molecular testing for IL-6, CD3, CD147, and beta 1 integrins as well as pAkt expression. Results: The data showed that the induction of IBD in the syndecan-1 KO mice was more severe at the clinical, histological, and molecular levels than in the wild type. The combined CypA-CyA treatment showed no added inhibitory effect compared to single-drug treatment in both strains. Probiotics added to the combination was more effective in the wild type and, when used alone, its inhibition of IL-6 was the highest. As for the CD147 marker, there were more suppressions across the various groups in the KO mice except for the probiotics-alone group. Concerning CD3, it was significantly increased by the CypA-CyA complex, which led to more inflammation in the KO mice. Probiotics had little effect with the combination. In relation to beta 1 integrins, the CypA-CyA combination made no significant difference from CyA alone, and adding probiotics to the combination resulted in higher beta 1 integrin expression in the KO mice. As for pAkt, it was very well expressed and upregulated in both strains treated with DSS, but the effect was much larger in the KO mice. In brief, the CypA-CyA complex showed a decrease in the expression of pAkt, but there was no added effect of both drugs. Probiotics along with the complex had a similar reduction effects in both strains, with a greater effect in the wild-type mice, while probiotics alone led to a similar reduction in pAkt expressions in both strains. Conclusions: The differential effects of CyA, CypA, probiotics, and their combinations on the various inflammatory markers, as well as the histological alterations and clinical signs and symptoms, speak in favor of a clear role of syndecan-1 in reducing inflammation. However, probiotics need to be considered after more explorations into the mechanisms involved in the presence of CypA and CyA especially since pAkt is less active in their presence.

Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries.

Despite the high prevalence of osteoporosis and vitamin D deficiency, the knowledge about osteoporosis and vitamin D-related practices were moderate in some countries in the Middle East and North Africa (MENA) region. Improving knowledge through awareness campaign and screening programs is essential to enhance vitamin D-related practices. PURPOSE: Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region. METHODS: A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices. RESULTS: Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001). CONCLUSION: Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.

Current state of clinical trials on xenograft.

BACKGROUND: Xenotransplantation is a worth investing branch of science, since it aims to fulfil the demand on human cells, tissues and organs. Despite decades of consistent work in preclinical assessments, clinical trials on xenotransplantation are far from reaching the targeted goal. Our study aims to track the characteristics, assess the content and summarize the plan of each trial on skin, beta-island, bone marrow, aortic valve and kidney xenografts, leading to a clear sorting of efforts made in this field. METHODS: In December 2022, we searched clinicaltrial.gov for interventional clinical trials related to xenograft of skin, pancreas, bone marrow, aortic valve and kidney. A total of 14 clinical trials are included in this study. Characteristics on each trial were gathered. Linked publications were searched using Medline/PubMed and Embase/Scopus. Content of trials was reviewed and summarized. RESULTS: Only 14 clinical trials met our study's criteria. The majority were completed, and most of the trials' enrolment was between 11 and 50 participants. Nine trials used a xenograft of porcine origin. Six trials targeted skin xenotransplantation, four targeted ß-cells, two targeted bone marrow and one trial targeted each of the kidney and aortic valve. The average length of trials was 3.38 years. Four trials were conducted in the United States and two trials in each of Brazil, Argentina and Sweden. Of all the included trials, none had any results provided and only three had published work. Phases I, III, and IV had only one trial each. A total of 501 participants were enrolled in these trials. CONCLUSION: This study sheds the light on the current state of clinical trials on xenograft. Characteristically, trials on this field are of low number, low enrolment, short duration, few related publications and no published results. Porcine organs are the most used in these trials, and skin is the most studied organ. An extension of the literature is highly needed due to the variety of conflicts mentioned. Overall, this study sheds the light on the necessity of managing research efforts, leading to the initiation of more trials targeting the field of xenotransplantation.

Highlights on two decades with microbiota and inflammatory bowel disease from etiology to therapy.

Inflammatory Bowel diseases (IBDs) constitute a complex panel of disorders characterized with chronic inflammation affecting the alimentary canal along with extra intestinal manifestations. Its exact etiology is still unknown; however, it seems to be the result of uncharacterized environmental insults in the intestine and their immunological consequences along with dysbiosis, in genetically predisposed individuals. It was the main target of our team since 2002 to explore the etiology of IBD and the related role of bacteria. For almost two decades, our laboratory, among others, has been involved in the reciprocal interaction between the host gastrointestinal lining and the homing microbiota. In the first decade, the attention of scientists focused on the possible role of enteropathogenic E. coli and its relationship to the mechanistic pathways involved in IBD induced in both rats and mice by chemicals like Iodoacetamide, Dextran Sodium Sulfate, Trinitrobenzene, thus linking microbial alteration to IBD pathology. A thorough characterization of the various models was the focus of research in addition to exploring how to establish an active homeostatic composition of the commensal microbiota, including its wide diversity by restoration of gut microbiota by probiotics and moving from dysbiosis to eubiosis. In the last six years and in order to effectively translate such findings into clinical practice, it was critical to explore their relationship to colorectal cancer CRC both in solid tumors and chemically induced CRC. It was also critical to explore the degree of intestinal dysbiosis and linking to IBD, CRC and diabetes. Remarkably, the active mechanistic pathways were proposed as well as the role of microbiota or bacterial metabolites involved. This review covers two decades of investigations in our laboratory and sheds light on the different aspects of the relationship between microbiota and IBD with an emphasis on dysbiosis, probiotics and the multiple mechanistic pathways involved.

Menstrual abnormalities post-COVID vaccination: a cross-sectional study on adult Lebanese women.

BACKGROUND: In the year 2020, the coronavirus pandemic invaded the world. Since then, specialized companies began to compete, producing many vaccines. Coronavirus vaccines have different adverse events. Menstrual disorders have been noticed as a common complaint post-vaccination. AIM: Our study fills an important gap by evaluating the relationship between coronavirus vaccines and menstrual disorders. METHODS: This is a cross-sectional study between 20 September 2021, and 1 October 2021, using an online survey. The questionnaire consisted of 36 questions divided into 4 sections: demographics, COVID-19 exposure and vaccination, hormonal background, and details about the menstrual cycle. Sample t-test, ANOVA test, chi-square, and McNemar test were used in bivariate analysis. RESULTS: This study includes 505 Lebanese adult women vaccinated against COVID-19. After vaccination, the number of women having heavy bleeding or light bleeding increased (p = 0.02 and p < 0.001, respectively). The number of women having regular cycles decreased after taking the vaccine (p < 0.001). Irregularity in the cycle post-vaccination was associated with worse PMS symptoms (p = 0.036). Women using hormonal contraception method or using any hormonal therapy had higher menstrual irregularity rates (p = 0.002 and p = 0.043, respectively). Concerning vaccine adverse events, those who had headaches had a higher rate of irregularity (p = 0.041). Those having PCOS, osteoporosis, or blood coagulation disorders had higher irregularity rate (p < 0.001 and p = 0.005, respectively). CONCLUSION: Vaccine adverse events may include specific menstrual irregularities. Moreover, some hormonal medications and diseases are associated with the alteration of the menstrual cycle. This study helps in predicting vaccines' menstrual adverse events, especially in a specific population prone to menstrual disorders.

Competencies required for graduated physicians: the integration of Englander's common taxonomy in a validated scale for the assessment of competency acquiring in undergraduate medical education.

BACKGROUND: Competency-based medical education has been emerging as a new educational model for learning. The development of medical education in Middle Eastern countries lacks basic literature in the area of medical education, particularly competency-based medical education (CBME). AIM: Our objective is to validate a brief/rapid scale that informs us on the current perception of the acquiring of competencies of medical students and graduates from the Lebanese University, Lebanon. METHODS: A survey containing the Englander's common taxonomy for medical competencies-a set of 57 items-was distributed to medical students and graduates from the Lebanese University. Three parameters were used for the validation of this scale: construct validity using the principal component analysis technique, internal reliability using Cronbach alpha, and convergent validity using Pearson correlation. RESULTS: A total of 377 participants responded to the survey. Factor analysis, using Varimax rotation, showed appropriate loading of domains; loadings varied between 0.648 and 0.899. Construct validity showed for all competencies loaded appropriately in their respective domains; loadings ranged between 0.656 and 0.913. Cronbach alpha values were very good to excellent (0.868 to 0.932). Pearson correlation coefficients showed a good correlation with the total score and varied between 0.739 and 0.893 (p < 0.0001). CONCLUSION: The Englander's common taxonomy scale is valid and reliable among Lebanese medical students and could be used for concise assessment of current and past medical education in faculties among Lebanese medical students. Using such scales can be used in assessing the improvement of medical education towards CBME.

Cancer research activity in the Arab world: a 15-year bibliometric analysis.

BACKGROUND: The Arab region comprises 22 countries located in the Middle East and North Africa, sharing cultural and linguistic ties. Arab countries have continued to lag in terms of biomedical research compared to other nations for several past decades. Cancer is a major public health concern, being the second leading cause of death globally. Given that high research activity on cancer reflects positively on screening programs, awareness, and clinical practice, this article aimed to examine the activity and trend of cancer research in the Arab world between 2005 and 2019. METHODS: Between 2005 and 2019, the number of cancer-related articles published by each Arab country, and regarding 27 different types, was assessed using the PubMed database. Numbers were normalized with respect to each country's average population and average Gross Domestic Product (GDP). RESULTS: Arab countries contributed to 1.52% of total cancer publications. The number of cancer publications has steadily grown since 2005, with the last 7 years alone witnessing 75.69% of the total Arab cancer-related publications. In terms of publications per million persons, Qatar ranked first (393.74 per million persons), while in terms of publications per national GDP, Egypt ranked first (464.27 per billion US dollars). Breast, liver, and colorectal cancers had the highest numbers of all Arab cancer-related publications, while testicular, vulvar, and gallbladder cancers had the least. CONCLUSIONS: This paper pools information and insight for scientists, clinicians, funders, and decision-makers on the actualities and developments of cancer research in the Arab world. Addressing the barriers facing cancer research remains a cornerstone in the plan to improve the Arab world's output and contribution to the field of oncology.

Current state of clinical trials regarding lung transplant rejection.

BACKGROUND: Over the last several decades, the field of lung transplantation has made significant advances. Despite these advancements, morbidity and mortality rates are still high when compared to other solid organ transplants. Clinical trials have a significant role bringing new medications with better effects than their predecessors. Our study is critical in evaluating and tracking clinical trials involving rejection of lung transplant, with a focus on interventional therapeutic trials. METHODS: On November 3, 2021, we searched clinicaltrial.gov for interventional clinical trials related to lung transplant rejection. A total of 39 clinical trials are included in this study. Characteristics on each trial were gathered. Linked publications were searched using Medline/PubMed and Embase/Scopus, and their content reviewed and summarized. RESULTS: The majority of trials were divided into completed (15 out of 39) and recruiting (12 out of 39). 17 trials had between 11 and 50 participants, and 8 had above 100. Only 1 trial lasted >10 years, and the average length of all trials was 3.6 years. The majority of trials were conducted in Europe/UK/Russia and the United States/Canada (17 and 18 trials, respectively). The results were provided in 3 trials, and also published in 3, showing a decrease in the rate of patients reaching an endpoint after chronic rejection with liposomal aerosol cyclosporine, a decrease in their cytokines level, and an increase in their 5-year-survival rate compared to the oral conventional immunosuppressant, the benefit of sirolimus in decreasing the acute rejection rate and severity in comparison to azathioprine, and its efficacy against cytomegalovirus infections. Other trials revealed the benefits of azithromycin in remarkably decreasing airways and systemic inflammation, with a concomitant decline in the risk of both BOS and CLAD; highlighting the deleterious effects of air pollution after transplantation surgery; and using the grading biopsy as a post-transplantation assessment tool. CONCLUSION: This study is a descriptive analysis of clinical trials targeting lung transplant rejection. This study shows the low number of trials, lack of variety in location and low publishing rates. Although focus of published trials was mainly towards azithromycin, bronchiolitis obliterans syndrome, air pollution, and biopsy in grading, a remarkable progress was realized concerning therapies, leading to less complications with a delay of chronic rejection onset, and an increase in overall survival. This sheds the light on the need for managing research efforts to fulfill any lack in specific domain, leading to new, effective therapies, and providing thereby much more benefit.

Breast Cancer Epidemiology and Contemporary Breast Cancer Care: A Review of the Literature and Clinical Applications.

Substantial progress has been made in contemporary breast cancer care, resulting in a consistently declining breast cancer mortality rate and an improvement in quality of life. Advancements include deescalation of therapy in low-risk populations and refining systemic therapy options. Research into molecular biomarkers continues to evolve and holds the promise of achieving the goal of precision medicine, while guidelines for supportive care and survivorship have been created to address the needs of an ever-increasing number of breast cancer survivors. A collaborative, multidisciplinary team approach is essential for patients and survivors to achieve optimal outcomes and enjoy productive high-quality lives. Gynecologists, in particular, play a key role in screening and survivorship care.

Epidemiology of Ocular Malignancies Among the Lebanese Population: A 12-Year Review.

Purpose Our article aims to assess the epidemiology of eye cancer in Lebanon and compare it with other regions worldwide and to study its future trends among Lebanese males and females. Methods Data on eye cancer cases from 2005 to 2016 were obtained from the Lebanese National Cancer Registry (NCR). Age-specific rates, crude rates, and age-standardized rates (ASRs) were subsequently calculated. Joinpoint was used to determine the changes in the slope of trends. A projection for the next 14 years was predicted using linear and logarithmic regression models. Results Among all tumors, eye cancer ranked 40 in females and 41 in males. The eye cancer ASR was 0.24 and 0.22 per 100,000 in males and females, respectively. However, the mean age of eye cancer was 31.94 years in males and 22.04 years in females. The cumulative risk between 0 and 74 years was 0.02%. From 2004 till 2016, a negative trend of eye cancer was observed, with a parallelism of trends between males and females. Age-specific rates showed a bimodal distribution in males. The first cluster was witnessed in the age group of 0-4 years and the second one in those above 50. An additional cluster of distribution was observed in females between 35 and 44 years of age. Forecasts for the next 14 years revealed a steady rate of eye cancer incidence of about 0.2 per 100,000. Moreover, Lebanon showed a relatively low eye cancer ASR compared to other regions worldwide, especially Zimbabwe with 5.8 and 4.8 per 100,000 in females and males, respectively. Conclusion Ocular malignancies showed a negative trend of incidence. A 14-year projection predicts a steady incidence rate in Lebanon and worldwide. Eye cancer seems to be affected by many risk factors. Future efforts are needed for a better understanding of the disease and a better outcome.

Effects of night eating and binge eating disorders on general health in university students in Lebanon.

BACKGROUND: Eating disorders (EDs) have an important impact on both physical and mental wellbeing, especially in a young population. There is a lack in research about EDs in the Middle East, and especially in Lebanon, where the co-occurring obesity is a widespread health problem. AIM: Our study aims to assess the relation between night eating syndrome (NES) with binge eating disease (BED) and obesity (BMI) on one hand, and between NES and general health on the other hand, in university students. MATERIALS AND METHODS: An observational cross-sectional study was conducted on 460 university students in Lebanon. Data collection was carried out using an online questionnaire. Socio-demographic and general health characteristics, BMI, Arabic validated General Health Questionnaire (GHQ-12), Arabic validated Binge Eating Scale (BES) and the Night Eating Diagnostic Questionnaire (NEDQ). Statistical analysis was accomplished on SPSS. RESULTS: Participants having highest income showed highest NEDQ score. Females and participants with a history of eating disorders were more likely to have BED. A significant correlation was also found between having an ED history and negative impact on general health. BMI was correlated with both NEDQ and BES. Having NES was associated with also having BED. Furthermore, those with NES showed higher scores regarding GHQ-12. CONCLUSION: Relatively high prevalence of NES and BED was noted in university students in Lebanon. This was correlated to a household income, general health, and BMI. The repercussion on both physical and mental morbidities highlights the importance for stepping up of the Lebanese organizational system to perform periodic screening.

Contribution of Arab countries to Behçet disease research: a PubMed-based bibliometric and altmetric analysis.

Behçet's disease (BD), a rare multisystemic disorder, has an unknown etiology. Interactions between genetic and environmental factors play a major role in this disorder. Human leukocyte antigen B51 allele is the strongest risk factor for the development of Behçet disease. The high prevalence of BD in the Arab world makes it necessary to undergo local research and publications, to target particular genetic, geographical, or even cultural risk factors. This study aims to assess the numerical contribution of the Arab world to research on Behçet disease. Using the PubMed platform, the number of BD-related publications from 2005 to 2019 was assessed for all 22 Arab countries, and countries having the highest prevalence of the disease. Number of publications on BD was normalized to the average population size and GDP for each Arab country. From 2005 to 2019, Arab countries published 198 articles related to BD. This accounts for 0.1% of the total number of BD-related articles published in this period (4170). A significant, positive correlation of moderate strength exists between the number of publications and the average population, while a non-significant, positive correlation of week strength exists between the number of publications and GDP. Concerning the top 15 countries according to Behçet disease prevalence, Turkey had the greatest number of articles, while the USA had the highest ratio of publications per prevalence. The high prevalence of BD in Arabic countries was faced by paradoxically low research activity in this field. Arab countries are lagging behind in the field of Behçet disease-related research, which highlights the need for improving research productivity.

Complete recovery of complicated methotrexate-induced liver cirrhosis in a patient with psoriasis: A case report.

Cirrhosis is the most common indication for liver transplant. Literature addressing methotrexate (MTX)-induced liver cirrhosis in patients with psoriasis is sparse. We present a case of a nonalcoholic patient diagnosed with psoriasis that was treated with a weekly 5 mg dose of methotrexate, a chemotherapeutic and immunological modulator, for five years. The patient presented after five years with abdominal distension and lower limb edema along with ascites and esophageal varices and was diagnosed with liver cirrhosis. Upon the discontinuation of MTX, the patient showed clear regression of ascites and esophageal varices, and recovery of liver cirrhosis by de-escalating from Child-Pugh B to A. After five years of follow-up, Echography and Transient Elastography (Fibroscan) of the liver confirmed the full recovery of liver cirrhosis by the absence of steatosis and fibrosis. This study emphasizes the reversibility of MTX-induced liver cirrhosis: cirrhosis is not aggressive, can be reversible, and is dose- and duration-dependent.