Assessment of Dietary Supplements Use among American University of Beirut Students: Prevalence, Knowledge, and Reasons for Supplementation.

The purpose of this study was to evaluate the prevalence and type of supplements used among university students, level of knowledge in this respect, reasons to supplement their diet, and the sources for information about dietary supplements. A sample of 100 students at the American University of Beirut were surveyed through a questionnaire composed of 22 questions and divided into four sections: socio-demographic, anthropometric, dietary supplement (DS) knowledge, DS intake and reasons. Descriptive statistics were conducted to determine the frequency of respondents for each variable and appropriate statistical tests were used for associations according to variable type and data. A total of 100 participants were included in the study of which 49 (49.0%) were males and 51 (51.0%) were females. Sixty-eight participants were dietary supplement users, of which 27 (39.7%) were males and 41 (60.3%) were females. Supplementation reasons differed: 53 consumed supplements to improve energy and vitality, 22 to enhance cognitive performance, 22 to promote hair, skin and health, and 13 to prevent or treat cold. A significant association was observed between dietary supplements use and female gender (OR = 5.66, 95% CI: 1.60-20.10). No significance was found between consuming dietary supplements and smoking status, BMI, living conditions, medical condition, age, exercise, major, dietary knowledge, and side effects. More than half of the participants are dietary supplements users with females being more likely to use them. The main reason for both genders to resort to dietary supplement use is to improve their energy and vitality.

Sacrococcygeal Local Anesthesia for Complicated Versus Uncomplicated Pilonidal Sinus Surgery: A Single Center Study.

BACKGROUND: Several anesthetic techniques have been used for pilonidal sinus surgery such as general, spinal, and local anesthesia infiltration. However, the most effective technique remains controversial. The aim of this study was to assess the effectiveness of sacrococcygeal local anesthesia for complicated pilonidal cysts in terms of postoperative analgesic consumption. METHODS: This was a retrospective cohort study conducted by collecting data from medical records for male patients who underwent pilonidal surgery using sacrococcygeal local anesthesia from 2008 to 2018. Patients' demographics, operative data, and postoperative outcomes such as pain, nausea, as well as analgesic consumption at 0 and 3 hours were analyzed. Pain scores at rest and upon pressure were recorded using the Visual Analogue Scale. The length of complicated pilonidal sinus was considered to be greater than or equal to 7 cm with multiple openings. RESULTS: A total of 394 patients were included in the study, 173 patients (43.9%) had complicated cysts while 221 patients (56.1%) had uncomplicated cysts. The majority of patients were males (85.5% vs. 76.9% in the complicated and uncomplicated groups respectively). Patients' weight was significantly higher in the complicated cyst group (87.12 ± 17.07 vs. 82.43 ± 20.30 kg, P value = 0.02). Around 41% of the patients in the complicated group were obese (body mass index ≥ 30 kg/m^2) compared to 32.0% of the patients in the uncomplicated group. Mean arterial pressure and heart rate at baseline, intraoperatively and at the end of the operation were similar between the two groups. Pain scores at rest and upon pressure were low in both groups. Analgesic consumption was similar between the two groups. Eight patients (4.6%) in the complicated group required acetaminophen at 0 hour compared to 6 patients (2.7%) in the uncomplicated group. Three patients (1.7%) received ketoprofen at 0 hour in the complicated group and 3 patients (1.4%) in the other group. Three patients, 2 (1.2%) in the complicated group and 1 (0.5%) in the second group required tramadol hydrochloride. CONCLUSIONS: Sacrococcygeal local anesthetic technique for complex pilonidal sinus surgery provided intra-operative hemodynamic stability as well as low post-operative pain and analgesic consumption.

Epidemiology, risk factors, and prediction score of carbapenem resistance among inpatients colonized or infected with 3rd generation cephalosporin resistant Enterobacterales.

In this study, we determined the incidence and risk factors of Carbapenem-resistant Enterobacterales (CRE) acquisition in inpatients with 3rd generation cephalosporin-resistant (3GCR) Enterobacterales at a tertiary-care hospital in Lebanon, and suggested a risk prediction score for it. This is a retrospective matched case-control study of inpatients with 3GCR Enterobacterales that are carbapenem resistant (cases) versus those with carbapenem-sensitive isolates (controls). Data analysis was performed on IBM SPSS program, version 23.0 (Armonk, NY, USA: IBM Corp.). Categorical variables were compared between cases and controls through bivariate analysis and those with statistical significance (P < 0.05) were included in the forward stepwise multiple logistic regression analysis. To develop the CRE acquisition risk score, variables that maintained statistical significance in the multivariate model were assigned a point value corresponding to the odds ratio (OR) divided by the smallest OR identified in the regression model, and the resulting quotient was multiplied by two and rounded to the nearest whole number. Summation of the points generated by the calculated risk factors resulted in a quantitative score that was assigned to each patient in the database. Predictive performance was determined by assessing discrimination and calibration. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different cutoffs of the score. The incidence of CRE acquisition significantly increased with time from 0.21 cases/1000 patient-days (PD) in 2015 to 1.89 cases/1000PD in 2019 (r2 = 0.789, P = 0.041). Multivariate analysis of matched data revealed that the history of cerebrovascular disease (OR 1.96; 95% CI 1.04-3.70; P = 0.039), hematopoietic cells transplantation (OR 7.75; 95% CI 1.52-39.36; P = 0.014), presence of a chronic wound (OR 3.38; 95% CI 1.73-6.50; P < 0.001), endoscopy done during the 3 months preceding the index hospitalization (OR 2.96; 95% CI 1.51-4.73; P = 0.01), nosocomial site of acquisition of the organism in question (OR 2.68; 95% CI 1.51-4.73; P = 0.001), and the prior use of meropenem within 3 months of CRE acquisition (OR 5.70; 95% CI 2.61-12.43; P < 0.001) were independent risk factors for CRE acquisition. A risk score ranging from 0 to 25 was developed based on these independent variables. At a cut-off of ≥ 5 points, the model exhibited a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 64.5%, 85.8%, 82%, 70.7% and 75%, respectively. We also showed that only meropenem consumption intensity and CRE acquisition incidence density showed a strong positive correlation(r = 0.798, P = 0.106), unlike imipenem (r = - 0.868, P = 0.056) and ertapenem (r = 0.385, P = 0.522). Patients with a score of ≥ 5 points in our model were likely to acquire CRE. Only meropenem was associated with CRE carriage. Our proposed risk prediction score would help target surveillance screening for CRE amongst inpatients at the time of hospital admission and properly guide clinicians on using anti-CRE therapy.