Prevalence of intestinal parasites during pre- and post-COVID-19 pandemic at a tertiary care center in Lebanon.

INTRODUCTION: Intestinal parasitic infections (IPIs) are a major medical and public health problem, especially in developing countries. This study aimed at comparing the prevalence and types of IPI during pre- and post-COVID-19 pandemics, and with data reported in Lebanon a decade ago. METHODOLOGY: Stool specimen results from a total of 4,451 and 4,158 patients were examined using the concentration method during the pre-covid (2017-2018) and post-covid (2020-2021) pandemic periods, respectively. Demographic information related to patient's age and gender was recorded. RESULTS: The overall positive detected parasites among the total tested in these two periods were 589 (13.2%) and 310 (7.5%), respectively. The protozoa accounted for most parasites (e.g., Blastocystis hominis, Entamoeba coli (E. coli), Entamoeba histolytica, and Giardia lamblia). Only B. hominis and E. coli showed significant differences; B. hominis was more prevalent in the post-covid period (33.5%) whereas E. coli in the pre-covid phase (44.5%). Among gender, E. histolytica was higher in males during the post-covid period (13.3% vs. 6.3%). Regarding age, adults (between 26 and 55 years) had the highest prevalence, with a noticeable decrease among the elderly in the post-covid time. Compared to the previous decade, the prevalence of B. hominis and E. coli remained higher, and that of E. histolytica and G. lamblia was almost the same. CONCLUSIONS: These findings indicate an overall reduction in the prevalence of IPI during the post-covid period, though IPIs persistence remains high. This highlights the need for enhancing public health awareness efforts to improve hygiene and sanitation to reduce parasitic prevalence in Lebanon.

Role of vitamin B12 in treating recurrent aphthous stomatitis: A review.

Vitamin B12, a water-soluble vitamin, plays a vital role in the formation of hematopoietic stem cells and has been associated with oral mucosal diseases, mainly recurrent aphthous stomatitis (RAS). The latter is a debilitating condition, and B12 was proposed as a potential treatment given its role in regenerating oral mucosal tissue. There is conflicting evidence that B12 deficiency causes RAS. Five of the seven randomized controlled trials reviewed used the inactive form of B12 (cyanocobalamin) as intervention, while the other two used the active form (methylcobalamin). Of the latter two, buccal discs (500 µg B12) showed significant improvement and reduced perceived pain in 77% of the subjects, and submucosal injections showed a significant difference in pain, starting from the second day. Moreover, three studies administered vitamin B12 sublingually with different dosages, which revealed that the higher dose (1000 µg) achieved a significant reduction in outbreaks, number, and duration of ulcers, especially after six months. Multivitamins showed no difference in new RAS episodes and duration. Injectable B12 was compared with the oral form, and nearly 50% of the injection group reported a desired response by the eighth week. An ointment form (500 µg) showed a significant reduction in pain levels after two days of treatment. Based on the available literature, we suggest that a daily dose of 1000 µg of vitamin B12 sublingually for six months can be used to treat RAS. Nevertheless, this conclusion should be considered tentative due to the lack of high quality, large scale studies.