Beliefs and practices of physicians in Lebanon regarding promotional gifts and interactions with pharmaceutical companies.

Background: Pharmaceutical companies invest greatly in promotional gifts to influence prescription of medications by physicians, yet there is limited published information evaluating its impact on healthcare. Aim: This study aimed to assess the beliefs and practices of physicians in Lebanon regarding promotional gifts and their interactions with representatives of pharmaceutical companies. Methods: This cross-sectional study was conducted between December 2019 and January 2020 through an email-based questionnaire sent to 5936 physicians of different specialties registered in the Lebanese Order of Physicians. Assessment was done using a validated tool and data analysis was conducted using SPSS version 26.0. Results: Of the 268 respondents, 188 (70.4%) reported that physicians in Lebanon accepted gifts from representatives of pharmaceutical companies. Most of the physicians (31.7%) interacted with company representatives more than once a week. Medication samples (251 respondents) and stationary items (222 respondents) were the most common gifts accepted by physicians who admitted accepting gifts. Overall, 225 (84.9%) respondents believed that prescriptions by physicians in Lebanon were influenced by the gifts. Only 74 (40.0%) of those who accepted gifts from pharmaceutical companies believed that it was unethical, and around half did not know if the Lebanese Code of Medical Ethics allowed them to accept gifts from pharmaceutical companies. Conclusion: Although physicians in Lebanon were aware of the effect that gifts from pharmaceutical companies could have on their prescription behaviours, many of them still accepted the gifts. This study provides evidence to policymakers for decision-making regarding ethical guidance on interactions between physicians and pharmaceutical companies in Lebanon.

Pericardial effusion complicated by umbilical vein catheter in a preterm infant with respiratory distress syndrome: A case report.

Respiratory distress syndrome (RDS) is the most common respiratory illness in premature infants. This syndrome is characterized by a deficiency in surfactant, necessary for proper lung function. Serious complications of RDS include pericardial effusion and pulmonary hypertension. Although pericardial effusion is a rare complication of RDS, it is potentially fatal if not treated. The most common cause of pericardial effusion (PCE) is the placement of a central venous catheter (CVC), a widely used procedure in neonatal intensive care unit to support premature infants. In this paper, we report a case of a 36 + 4 weeks preterm male infant presenting for RDS. During his hospital stay, at 24 hours of life, the patient started to develop bradycardia where he was intubated. After 48 hours of birth, a central venous catheter was inserted, and on echocardiography results showed pericardial effusion, and pulmonary hypertension.