RESUMO
BACKGROUND: Asthenopia or eye strain is one of the major medical problems that students face during their academic years. OBJECTIVES: The aim of this study is to determine the prevalence of asthenopia among a sample of university students attending various majors and to identify the risk factors for its development. METHODS: This is a cross sectional study conducted on students attending various faculties at the American University of Beirut during the spring semester of 2019. Students were asked to fill a self-administered anonymous questionnaire that inquired about demographics, use of digital devices, symptoms of asthenopia, possible risk factors and protective measures. A bivariate analysis was performed to correlate asthenopia with the different variables. A multivariate analysis was then conducted to determine the extent of contribution of the different variables to asthenopia after controlling for confounding variables. RESULTS: The prevalence of asthenopia was found to be 67.8% with blurred vision being the most reported symptom (27.0%). A bivariate analysis was used to assess the association between asthenopia and the following variables: demographics, digital device use, reasons for using digital devices, and preventive methods. Age, being a continuous variable, was analyzed using an independent t- test. For the variables that were found to be have a p-value < 0.2, a multiple logistic regression was performed. Old age was found to be a protective factor for asthenopia, with 0.693 times reduction in asthenopia for every increase in year of age. Using the device for communication for less than four hours (p=0.012), using the device for less than four hours per day (p=0.000) and pattern of using the device for less than three years (p=0.023) were significant in being negatively associated with asthenopia. As for preventative measures that protect users from digital eyestrain, we found that using eye drops (p=0.004; OR=0.375) and taking regular breaks (p=0.000; OR= 0.399) were protective factors whereas using adjustable screens was a risk factor (p=0.000; OR=3.083). CONCLUSION: Asthenopia was found to be of non-negligible prevalence among this sample of university students. The results of this study highlight the importance of establishing awareness campaigns and encourage the introduction of targeted screenings for asthenopia among college students.
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INTRODUCTION: Malignant mesothelioma is a rare neoplasm of mesothelial cells arising most frequently in the pleura or peritoneum and less frequently in the liver. CASE PRESENTATION: We present a case of primary hepatic mesothelioma of 41year old woman. She had no history of asbestos exposure or cancer. Abdominal computed tomography (CT) showed 21cm intrahepatic mass in the right lobe with many cystic lesions and few small calcifications. Pathology showed a biphasic cellular pattern. In addition, the tumor cells were positive for Calretinin, Creatine Kinase (CK)5/6, CK7, CKAEI 1/3, Wilms Tumor protein (WT-1), and Vimentin, but were negative for Alpha Feto protein (AFP), Thrombotic Thrombocytopenic Purpura (TTP-1), Anti-Hepatocyte Specific Antigen (HSA), Synaptophysin, CK20, and Homeobox protein (CDx-2). DISCUSSION: Primary intrahepatic mesothelioma (PIHMM) is not included in the classification of the World Health Organization classification of hepatic tumors. Mesothelial cells are not normally found in the liver, but some reported cases suggest it may grow from the mesothelial cells of the Glisson's capsule. CONCLUSION: The probability of hepatic mesothelioma should not be ruled out, even in a young woman without a clear history of asbestos exposure.