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This study aims to examine the transformative power of literature in challenging prevailing social norms and reshaping perspectives on migration, alterity, and cultural marginalization. Focusing on the novels Once in a Promised Land by Layla Halaby, The Namesake by Jhumpa Lahiri, and Exit West by Mohsin Hamid, the analysis examines the representation of the individual Other, challenging stereotypes, and highlighting the characters’ personal and political traumas. The concept of nowhereness, which stands for the emotional and psychological state of migrants moving in unfamiliar cities, is explored, highlighting the paradoxical experience of simultaneous death and rebirth. The characters in these novels are in a deep state of emptiness, serving as “citizens in waiting and deportees in waiting.” Their experiences in the liminal space of waiting are closely intertwined, creating a shared temporal landscape that enriches the exploration of the complexity of migrants. In this regard, the authors challenge the conventional tactics of silencing voices and concealing images to transform the harrowing ordeals of the Other into a powerful means of social introspection. The authors engage with Western hegemony and imperialism, seeking to inspire understanding and admiration for subaltern cultures that are marginalized by the Western world.

Alzheimer’s disease (AD) is a prevalent neurodegenerative disorder characterized by progressive cognitive decline. Genetic factors have been implicated in disease susceptibility as its etiology remains multifactorial. The CD33 and the HLA-DRB1 genes, involved in immune responses, have emerged as potential candidates influencing AD risk. In this study, 644 Lebanese individuals, including 127 AD patients and 250 controls, were genotyped, by KASP assay, for six SNPs selected from the largest GWAS study in 2021. Logistic regression analysis assessed the association between SNP genotypes and AD risk, adjusting for potential confounders. Among the six SNPs analyzed, rs1846190G>A in HLA-DRB1 and rs1354106T>G in CD33 showed significant associations with AD risk in the Lebanese population (p < 0.05). Carriers of the AG and AA genotypes of rs1846190 in HLA-DRB1 exhibited a protective effect against AD (AG: OR = 0.042, p = 0.026; AA: OR = 0.052, p = 0.031). The GT genotype of rs1354106T>G in CD33 was also associated with reduced risk (OR = 0.173, p = 0.005). Following Bonferroni correction, a significant correlation of rs1354106T > G with AD risk was established. Our results might highlight the complex interplay between genetic and immunological factors contributing to the development of the disease.

Background: Effort–reward imbalance (ERI) refers to the situation where there is a mismatch between the effort that healthcare workers (HCWs) put into their work and the rewards they receive in return. Burnout, on the other hand, is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. This study aimed to assess the impact of ERI and burnout on the compliance with standard precautions (SPs) among nurses and midwives in Lebanese hospitals under the economic crisis and after the COVID-19 pandemic. Methods: Cross-sectional correlational study, based on self-administered questionnaire data, measuring the compliance with SPs, ERI, and burnout, in addition to the relationship between these factors, was performed among 409 nurses and midwives, working in Lebanese hospitals. Results: ERI was significantly associated with exposure to burnout among nurses and midwives, and burnout was found to be a significant predictor of nurses and midwives’ self-reported adherence with SPs. Conclusions: This study highlights the contribution of ERI and burnout to the chain of infection by decreased adherence to infection control SPs of nurses and midwives.

Abstract Inherited retinal dystrophies (IRDs) are a major cause of vision loss. Altogether are highly heterogeneous genotypically and phenotypically, exhibiting substantial differences worldwide. To shed more light on these conditions, we investigated the genetic and phenotypic landscape of IRDs in the Arabs globally and per country. We analyzed 1,621 affected individuals from 16 Arabic countries reported in 198 articles. At the phenotypic level, rod-cone dystrophy (RCD) and Usher syndrome were the most prevalent conditions among non-syndromic and syndromic IRDs. At the gene level, TULP1, ABCA4, RP1, CRB1, MYO7A, RPE65, KCNV2, and IMPG2 were the most mutated genes. Interestingly, all except CRB1 were highly prevalent because they harbored founder mutations, implying that consanguinity is a major determinant in Arab countries. Of note, ~ 93% of the investigated individuals carried homozygous mutations. The country analysis for the IRDs conditions and their associated genotypes revealed that whereas Leber Congenital Amaurosis, RCD, and USHER syndrome were widely distributed, bestrophinopathies and non-syndromic hearing loss were restricted to specific countries (till now). This study could be a starting point for initiating suitable health policies towards IRDs in the Arab world. The high degree of homozygosity urges the need for genetic counsellors to provide personalized information and support the affected individuals.

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in adults. We evaluated the immunohistochemical (IHC) expression of p63 and p53 in DLBCL and their significance on overall survival (OS) and progression-free survival (PFS). We conducted a retrospective cohort study of 177 patients with DLBCL who presented to Mount Sinai Medical Center of Florida (Miami Beach, Florida) between 2010 and 2020. IHC staining for p63 and p53 protein expression was performed. A significant correlation was found between p63 positivity and p53 expression, p53/p63 co-positivity, Ki-67 proliferation index, MYC expression, and MYC/BCL2 double expression. Regardless of the germinal center B-cell like (GCB) subgrouping, there was a trend among p53+ patients to have MYC/BCL2 double expression, positive MYC expression, and lower OS and PFS. A tendency of poor OS was seen in p53+ patients in the non-GCB, GCB, and double expressors subgroups and poor PFS in p53+ patients regardless of the subgrouping. In conclusion, our results suggest that p63 and p53 may represent potential additional prognostic biomarkers in DLBCL and may be included in the initial diagnostic work up of patients with DLBCL.

Our home, the earth is on fire; nature continues to be assailed by pollution and despoliation; the 21st century’s most serious hazard, COVID-19 has been threatening global health. Richard Powers, in Bewilderment portrays the near dystopian future that is teetering on the brink of various social and environmental collapses. Theo Byron, a widowed astrobiologist narrates his life story with his son Robin, who has been diagnosed with multiple behavioural issues. Robin is experiencing eco-anxieties and his mental issues grant him an accomplished personality with a unique point of view. Through a bittersweet weaving of facts, fiction, philosophy and science, Powers displays the tragedy of our lives and its unavoidable connection to nature and the universe. Following the examination of Robin’s particular brain difference, this study attempts to display how Richard Powers uses the affective difference discourse proposed by Bergenmar and Jakob von Uexküll’s notion of “umwelt”, and takes a new look at the strengths and gifts of neurodiverse people, always misrecognized as deficient and abnormal. Moreover, through the related theories of Thomas Armstrong, who compares the human brain to the ecosystem, we shall analyse Bewilderment as a revisionist neuronovel, providing, through brain-related experiences, an opportunity for readers to view the world through a neurodivergent point of view.

The researchers intend to analyze John Fowles’ The French Lieutenant's Woman to depict how the female protagonists reject the notion of being eunuchs and experience liberation and revolution within the social context. To carry out this study, the researchers analyze the female characters. This masterpiece revolves around the notions of love and sexuality. The French Lieutenant's Woman has been analyzed from different aspects of feminism. However, in this research, the purpose is to depict how Victorian women are able to break the phallocentric discourse by negating sexual differences and becoming eunuch subjects. The beginning of the novel shows Charles’ engagement with Ernestina mostly based on the social doctrines of the Victorian era. In fact, there is no love between them and what binds them together is social expectation. Ernestina is the symbol of a woman who desires to be a female eunuch and obey the principles of the nuclear family. On the other hand, Sarah is a rebellious character who selects love over the social doctrines of Victorian society. The present research is conducted based on Luce Irigaray and Germaine Greer's theories in which the role of Victorian women is analyzed.

Abstract Non-syndromic rod-cone dystrophy (RCD) is the most common condition in inherited retinal diseases. The aim of this study was to evaluate the research output and productivity related to RCD genetics per countries as classified by the human development index (HDI), by analyzing publication frequency and citations, the choice of journals and publishers, since 2000 to date. We have also analyzed the use of next-generation sequencing (NGS) in publications originating from countries with different HDIs. One thousand four hundred articles focusing on non-syndromic RCD were downloaded and analyzed. Citations and published articles were adjusted per one million individuals. The research output is significantly higher in very high HDI countries (86% of the total publications and 95% of the citations) than countries with lower HDIs in all aspects. High and medium HDI countries published together 13.6% of the total articles worldwide and received 4.6% of the citations. On the publication level, the USA (26%), United Kingdom (10%), and Japan (7%) were the top 3 among very high HDI countries, while China (6%) and India (2%) ranked first in high and medium HDI countries respectively. On the citation level, similar profiles were found. Following adjustment for population size, Switzerland (~14%), Jordan (~ 1%) and Morocco (

Background Acute kidney injury (AKI) is a common cause of morbidity and mortality. It mainly targets the renal tubular epithelium with pathological changes, referred to as acute tubular injury. The latter is followed by a regenerative response that is difficult to visualize on routine hematoxylin and eosin (H&E) stains. In this study, we examined the regenerative capacity of renal tubules by correlating vimentin (VIM) immunohistochemical (IHC) expression and pathological findings of AKI and renal tubular regeneration (RTR) on H&E. Methods We reviewed 23 autopsies performed in the clinical setting of AKI and RTR. VIM expression was scored in the renal cortical tubular epithelium using a statistical cutoff ≥ 3% for high expression and < 3% for low expression. Results Of the 23 kidney tissues examined, seven (30.4%) had low VIM expression, and 16 (69.6%) had high VIM expression. Kidney tissues with evidence of AKI and RTR had significantly higher VIM expression. Renal peritubular microenvironment features showing regenerative changes on H&E were associated with high VIM expression. In the univariate model, kidney tissues with RTR were 18-fold more likely to have high VIM expression. Conclusions In conclusion, our findings suggest that VIM could serve as an IHC marker for RTR following AKI. However, correlation with H&E findings remains critical to excluding chronic tubular damage. Collectively, our preliminary results pave the way for future studies including a larger sample size to validate the use of VIM as a reliable biomarker for RTR.

Abstract The aim of this retrospective study was to assess the outcomes of non-surgical and surgical mechanical root debridement for the treatment of infrabony defects and explore potential prognostic factors. Treated infrabony defects followed for at least 1 year were selected. All data pertaining to the clinical outcomes were recorded. Multi-level regression analysis and Cox Proportional-Hazards Models were used to assess the immediate (3–6 months) clinical outcomes, survival of the treated teeth, and factors influencing these results. 132 patients were included in the analysis. The analysis showed 1.42 ± 1.71 and 2.23 ± 1.64 mm in pocket depth (PD) reduction, 0.13 ± 1.83 and 0.08 ± 1.76 mm in clinical attachment level (CAL) gain, and 1.29 ± 1.56 and 2.15 ± 1.33 mm increase in gingival recession (REC) for the non-surgical and surgical groups, respectively. The 5-year survival rates were 93% for the non-surgically and 90% for the surgically treated teeth. Several factors affected clinical outcomes and tooth survival. Within its limitations, the treatment of infrabony defects with non-surgical and surgical mechanical root debridement was found to result in moderate but significant PD reduction, nevertheless, this may also be attributable to the resultant REC.

Background and Aim: Brucellosis is endemic zoonotic and highly contagious bacterial disease. Recently, several brucellosis cases were reported in Lebanon, causing significant economic losses; however, no study was done so far on farms located in the southern part of the country. Thus, the aim of our study was to estimate the prevalence of Brucella abortus in South Lebanon using three different serological tests in the diagnosis of brucellosis in cattle. Materials and Methods: Seventeen farms from 14 locations in Southern Lebanon were selected. Two hundred and three bovine blood samples of different ages, and 121 milk samples collected from older than 2 years cattle were tested using different serological tests: Rose Bengal test (RBT), milk ring test (MRT), indirect enzyme-linked immunosorbent assay (I-ELISA), and confirmed with competitive ELISA (C-ELISA). Results: Results revealed that approximately 15.3% (confidence interval [CI] 95 10.3-20.2%) and 15.7% (CI 95 9.2-22.2%) of samples were positive using RBT and MRT, respectively. This percentage was significantly higher when using I-ELISA (18.3%) (CI 95 12.9-23.5%) and C-ELISA (18.7%) (CI 95 9.8-27.5%). Among used diagnostic tests, our results showed that ELISA was more accurate for the detection of brucellosis, especially since it detects the late stages of the infection, which is characterized by the presence of immunoglobulin G. The seroprevalence of brucellosis was higher among females. All positive tests were of cattle Holstein breed older than 2 years. Tyre and Jezzine cities had a higher significance in bovine brucellosis than Saida. A positive correlation between human and cattle brucellosis was found. Conclusion: Our results showed that bovine brucellosis is prevalent in southern Lebanon. Lack of research, in addition to little feedback of occurring illness or symptoms, creates a gap in helping to control the spread of the disease.

Background and Aim: Brucellosis is a zoonotic disease caused by the bacterium of the genus Brucella. This disease is present worldwide, especially in developing and underdeveloped countries, where it is endemic. This first-of-its-kind study in Lebanon aimed to assess the prevalence of brucellosis across the country and to determine the efficacy of a vaccine for reducing losses in herds so that its toll on public health is reduced. Materials and Methods: Three hundred and fifty-three blood serum and 261 milk samples were obtained from cows in different areas of Lebanon. The samples were analyzed using serological tests (rose Bengal, milk ring, and indirect enzyme-linked immunosorbent assay [ELISA]) and confirmed with competitive ELISA and polymerase chain reaction. Results: The highest rate of Brucellae was found in the Bekaa region (10%). After vaccination of 5 cows and 13 heifers at different times, the results showed that all the vaccinated animals have developed an immune response to brucellosis 60 days after vaccination. This vaccine can be considered as stable and preventative to protect against brucellosis in animals and thus protect the public from this infection. Conclusion: These findings will provide further insight into designing future targeted awareness interventions and adapted policies as efforts toward reducing the prevalence and prevention of brucellosis in cattle in Lebanon.

Abstract Background Acute gastroenteritis (AGE) is a major cause of pediatric morbidity and mortality around the world. It remains a frequent reason for infection-related admissions to emergency units among all age groups. Following the Syrian refugee crisis and insufficient clean water in our region, we sought to assess the etiological and epidemiological factors pertaining to AGE in South Lebanon. Methods In this multi-center cross sectional clinical study, we analyzed the demographic, clinical and laboratory data of 619 Lebanese children from the age of 1 month to 5 years old who were admitted with AGE to pediatrics departments of three tertiary care centers in South Lebanon. Results Our results revealed that males had a higher incidence of AGE (57.3%) than females. Enteropathogens were identified in 332/619 (53.6%) patients. Single pathogens were found in 294/619 (47.5%) patients, distributed as follows: Entamoeba histolytica in 172/619 (27.8%) patients, rotavirus in 84/619 (13.6%), and adenovirus in 38/619 (6.1%). Mixed co-pathogens were identified in 38/619 (6.1%) patients. Analyzing the clinical manifestations indicated that E. histolytica caused the most severe AGE. In addition, children who received rotavirus vaccine were significantly less prone to rotavirus infection. Conclusions Our findings alluded to the high prevalence of E. histolytica and other unidentified enteropathogens as major potential causes of pediatric AGE in hospitalized Lebanese children. This should drive us to widen our diagnostic panel by adopting new diagnostic techniques other than the routinely used ones (particularly specific for the pathogenic amoeba E. histolytica and for the unidentified enteropathogens), and to improve health services in this unfortunate area of the world where insanitary water supplies and lack of personal hygiene represent a major problem.

The paper explores the liberating power of Bhabha’s concept of hybridity in Manju Kapur’s novel The Immigrant. By concentrating on Nina’s immigration to Canada, the novel addresses her early affliction due to the cultural clash between the East and West, tradition and modernity, her assimilation problems, as well as her gradual assimilation, her in-betweenness, transformation in her roles and identity, and survival in the host world. She opens a space in-between the home and host culture, mediates between them, and becomes the citizen of two worlds; she thus enters the third space, i.e. she stands in-between two cultures prioritizing neither the home nor the host culture but the middle ground and emerges as a hybrid who occupies the in-between space and develops a double vision. Using Homi Bhabha’s insights, this study seeks to demonstrate that being positioned in the third space, i.e. moving beyond the polarities and challenging the fixedness of identity and experiencing in-betweenness – being neither one nor the other, might pave the way for her liberation. The paper is to show that Nina is neither one nor the other, i.e. neither a traditional nor a modern woman but both, simultaneously transcending and reconciling the tradition and modernity.

Aim: Investigate the effect of dietary exposure to chlorpyrifos on locomotion and contraction of soleus andextensor digitorum longus (edl) involved in locomotion. Methods: Rats were fed diets containing 1 or 5 mg kg−1 of chlorpyrifos for six weeks. Locomotion has been assessed weekly using beam walking and beam balance tests. Soleus and edl were removed to study contractile properties, myofibrillar protein content and myosin heavy chain isoforms. Results: Animals treated with 5 mg kg−1 chlorpyrifos had a decrease body weight. An increase by 28% and 24% in latency time assessed by beam walking test and a decrease by 9% and 13% in the beam balance time was reported after 6 weeks of 1 and 5 chlorpyrifos exposure respectively. The contractile properties in soleus showed an increase in twitch amplitude by 25% and 63% in 1 and 5 doses respectively, without modification in the contraction time and half relaxation time. edl treated with 1 mg kg−1 showed a decrease by 35%, 42% and 22% in twitch amplitude, contraction time and half relaxation time respectively. edl treated with 5 mg kg−1 showed an increase of 23% in twitch amplitude without modification of the other parameters. These changes were associated with modification of myofibrillar protein content in all treated groups. Myosin heavy chain isoforms were altered in both skeletal muscles treated with 1 mg kg−1. Conclusion: Exposure to chlorpyrifos can alter the locomotion and produce physiological changes in a dose and muscle type related manner. Keywords: Chlorpyrifos, Contraction, Extensor digitorum longus, Locomotion, Soleus

Background: Acute gastroenteritis is a very common infectious disease facing all age groups worldwide, especially the pediatric population. Viruses, bacteria, and parasites are all possible causes of infectious gastroenteritis; however, viruses have become more frequently identified with the advances in the ability to diagnose viral infections, particularly rotavirus and adenovirus. We aimed in our study to compare between the prevalence, risk factors, and clinical characteristics of rotavirus and adenovirus among children with viral gastroenteritis in Lebanon. Materials and methods: A 12-months retrospective study was performed between January 1st and December 31st, 2018 including 308 children aged 1 month to 12 years, who were admitted to three tertiary healthcare centers in South Lebanon. Medical data were retrieved from patients’ files, including clinical and laboratory information. Results: Rotavirus was found in stool of 204 patients (66.23 %), followed by adenovirus in 78 cases (25.32 %), and mixed group (rotavirus and adenovirus) in 26 cases (8.44%). The highest prevalence of rotavirus in our present study was seen among children between 12 and 23 months old, whereas patients infected with adenovirus were mainly aged between 24-35 months or 4–11 months. Majority of patients in the adenovirus and mixed groups had high-grade fever compared to the rotavirus group. Laboratory findings presented significantly higher average of white blood cells (WBCs), absolute neutrophil count (ANC), and C-reactive protein (CRP) in the mixed group compared to the two other groups. Monthly distribution of rotavirus and adenovirus infection revealed a biennial pattern of rotavirus incidence during January and July–August while frequency of adenovirus infection was highest during July–August. Conclusion: Due to the high prevalence of viral diarrhea among the pediatric age group in our region, particularly rotavirus and adenovirus, along with the associated non-specific signs and symptoms, we highly recommend that medical laboratories be equipped for virus detection. Also, vaccination against rotavirus should be considered as a prevention strategy.

Background and objectives: Vascular Endothelial Growth Factor (VEGF) is an essential regulator of vascular biology. In addition to the well-established role in angiogenesis, circulating VEGF levels were found elevated in severely anemic patients, pointing out that anemia might affect the progression of angiogenesis in malignant and benign diseases through the alteration of VEGF levels. Ten single nucleotide polymorphisms (SNPs) in VEGFA and other loci were shown to explain more than 50% of its circulating levels. This study investigated the association of those ten VEGF-related SNPs with serum iron levels in a general Lebanese population free of chronic diseases (N = 460). Result: We found that the rs10738760 and the body mass index (BMI) were associated with decreased Iron levels (p = 0.002, and p < 0.001, respectively). When taken together, both variables, rs10738760 and BMI, interacted to reduce iron levels (p < 0.001). According to obesity status, the stratification revealed that the effect of rs10738760 was more pronounced in obese than non-obese individuals (p = 0.025).Conclusion: The intergenic SNP rs10738760 is associated with circulating iron levels, and this association depends on BMI status.Although of interest, these results need replication in larger populations from different ancestries.

Rapid growing of mobile phones users has raised about the possible effects of these electromagnetic waves (EMW) on human health. Many studies have examined the role of these EMW on biological systems, but the results are still contradictory and controversial. In addition to EMW, over-activation of angiotensin type 1 receptor (AT1R) has been associated with cognitive decline, incidence and progression of neurodegenerative diseases. Candesartan, an AT1R blocker, is well recognized for treatment of hypertension. However, its role on cognitive functions such as spatial and recognition memory remains elusive. Thus, young rats were divided into 3 groups: control, exposed to radiofrequency electromagnetic waves (EMW), and exposed to EMW during Candesartan treatment (EMW+Cand). Spatial memory performance was assessed using the object recognition test and recognition memory performance using Morris water maze test. Significant differences where found between EMW exposed rats and EMW+Cand exposed rats treated with Candesartan compared to control, EMW group impaired learning, spatial and short term memory along with unaffected sensorimotor function whereas EMW+Cand group improved learning, spatial memory and short term memory deficit induced by EMW in addition to absence of its role on sensorimotor function. Although our data provides evidences of the protective role of Candesartan against EMW-induced cognitive decline, more future studies are still needed to confirm these findings which can provide new fields in treatment of EMW-induced damage by Candesartan. Keywords: Candesartan, Electromagnetic waves, Rats

This study explores Pynchon’s mammoth novel, Against the Day, in terms of the minor practice of language as proposed by Deleuze and Guattari in their book Kafka: Toward a Minor Literature, which opens up new possibilities for literary criticism. With his idiosyncratic, intensive, and inventive practice of language, Pynchon shatters the already existing notions of appropriate and homogenizing forms of major language. The novel demystifies the language’s institutionalized system of signification and defies identifiable decipherable meaning in many ways, such as covert and overt deterritorialization of language, escape from “territorial” and “representational” language, defiance of signification, neutralization of sense, asyntactical language, phantasmagorical and absurd tales, quizzical jokes, silly songs, and asubjective free indirect narration. Against the Day’s practice of language prefers the territory of asubjective insignification to subjective, symbolic, and signifying usage of language so as to dismantle the territory of representation; thus, it pushes the major language towards or even out of its limits.

The journal retracts the article, Effects of a Single Dose of Ivermectin on Viral and Clinical Outcomes in Asymptomatic SARS-CoV-2 Infected Subjects: A Pilot Clinical Trial in Lebanon [...]

Background: An outbreak of an unknown respiratory illness caused by a novel coronavirus, SARS-CoV-2, emerged in the city of Wuhan in Hubei Province, China, in December 2019 and was referred to as coronavirus disease-2019 (COVID-19). Soon after, it was declared as a global pandemic by the World Health Organization (WHO) in March 2020. SARS-CoV-2 mainly infects the respiratory tract with different outcomes ranging from asymptomatic infection to severe critical illness leading to death. Different SARS-CoV-2 variants are emerging of which three have raised concerns worldwide due to their high transmissibility among populations. Objective: To study the prevalence of COVID-19 in the region of Nabatieh-South Lebanon during the past year and assess the presence of SARS-CoV-2 variants and their effect on the spread of infection during times of lockdown. Methods: In our study, 37,474 nasopharyngeal swab samples were collected and analyzed for the detection of SARS-CoV-2 virus in suspected patients attending a tertiary health care center in South Lebanon during the period between 16 March 2020 and 21 February 2021. Results: The results demonstrated a variation in the prevalence rates ranging from less than 1% during full lockdown of the country to 8.4% upon easing lockdown restrictions and reaching 27.5% after the holidays and 2021 New Year celebrations. Interestingly, a new variant(s) appeared starting January 2021 with a significant positive association between the prevalence of positive tests and the percentage of the variant(s). Conclusions: Our results indicate that the lockdown implemented by the Lebanese officials was an effective intervention to contain COVID-19 spread. Our study also showed that lifting lockdown measures during the holidays, which allowed indoor crowded gatherings to occur, caused a surge in COVID-19 cases and rise in the mortality rates nationwide. More importantly, we confirmed the presence of a highly transmissible SARS-CoV-2 variant(s) circulating in the Lebanese community from at least January 2021 onwards.

Objective: This study was designed to determine the efficacy of ivermectin, an FDA-approved drug, in producing clinical benefits and decreasing the viral load of SARS-CoV-2 among asymptomatic subjects that tested positive for this virus in Lebanon. Methods: A randomized controlled trial was conducted in 100 asymptomatic Lebanese subjects that have tested positive for SARS-CoV2. Fifty patients received standard preventive treatment, mainly supplements, and the experimental group received a single dose (according to body weight) of ivermectin, in addition to the same supplements the control group received. Results: There was no significant difference (p = 0.06) between Ct-values of the two groups before the regimen was started (day zero), indicating that subjects in both groups had similar viral loads. At 72 h after the regimen started, the increase in Ct-values was dramatically higher in the ivermectin than in the control group. In the ivermectin group, Ct increased from 15.13 ± 2.07 (day zero) to 30.14 ± 6.22 (day three; mean ± SD), compared to the control group, where the Ct values increased only from 14.20 ± 2.48 (day zero) to 18.96 ± 3.26 (day three; mean ± SD). Moreover, more subjects in the control group developed clinical symptoms. Three individuals (6%) required hospitalization, compared to the ivermectin group (0%). Conclusion: Ivermectin appears to be efficacious in providing clinical benefits in a randomized treatment of asymptomatic SARS-CoV-2-positive subjects, effectively resulting in fewer symptoms, lower viral load and reduced hospital admissions. However, larger-scale trials are warranted for this conclusion to be further cemented.

Background: Urinary tract infections (UTIs) are major healthcare problems that are usually treated empirically. However, antimicrobial resistance has been increasing across many settings. This study aims to elucidate the antibiotic resistance profiles of three common uropathogens, Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Proteus mirabilis (P. mirabilis) and compare between extended spectrum beta-lactamase (ESBL) and non-ESBL strains among Lebanese patients. Methods: This retrospective study was conducted at multiple tertiary healthcare centers in South Lebanon, between January and September 2017, including 551 patients of all age groups. Demographic, clinical, and laboratory data of patients were collected and analyzed statistically. Results: The prevalence of UTI in Lebanon was highest in adults between 19 and 64 years (44%). E. coli was the predominant uropathogenic organism (67.1%) followed by K. pneumoniae (10%) and P. mirabilis (3.7%). ESBL represented 32.9% of the UTI agents. The three common uropathogens studied were found to be most susceptible to imipenem (100%) and meropenem (100%). Interestingly, 115 (25.1%) out of the 458 E. coli isolates were resistant to more than eight antibiotics while 107 (23.4%) were susceptible to all antibiotics studied. Conclusions: Our study underlined the importance of adequate antimicrobial prescription for UTIs in Lebanon to avoid multidrug resistance.

Background and Objective: Toll-like receptors (TLRs) are important components of the innate immune system, involved in establishing immunity to infections. Apart from being implicated in immunity, numerous studies have reported that many TLRs, including TLR2, are involved in the pathogenesis of cardiovascular diseases and their risk factors. Since rs1898830 is associated with TLR2-mediated cellular activation, we aimed to study its association with CVD risk factors, such as lipid levels and hypertension. Methods: A cross-sectional study was conducted on 460 individuals free from chronic diseases. Clinical and biological data were collected and DNA was extracted and genotyped using Kompetitive allele specific PCR (KASP™). Multiple logistic regression models, adjusted for six covariates, were used. A power calculation analysis was also performed. Results: We found that rs1898830 in TLR2 was positively associated with hypertension (OR = 2.18, p = 0.03) and negatively associated with high-density lipoprotein cholesterol (OR = 0.66, p = 0.05). In contrast, no relation was found with total cholesterol and low-density lipoprotein cholesterol. Conclusion: The present results provide additional evidence supporting the implication of TLR2 in CVD risk factors.

BACKGROUND:Anemia is a global health problem associated with short- and long-term consequences especially in children. The incidence of anemia along with the factors associated with its increased or decreased risk is not yet well studied in Lebanon. Our study aims at determining the demographics of this health burden and identifying some of the important factors linked to it among the pediatric population. METHODS:A 4-months cross-sectional study was performed between August and November 2017 including 295 children aged 1 month to 12 years, who were hospitalized in a tertiary care hospital located in South Lebanon. We analyzed the different demographic data, age, gender, breast feeding duration, solid food introduction, iron supplementation and disease of diagnosis in association with multiple hematological parameters. RESULTS:The prevalence of both mild and moderate anemia was 71.8 and 25.4%, with only 2 cases of severe anemia encountered among children aged 6 months or above. Results showed that the risk of anemia increases by around 3.4 folds among malnourished children than in well-nourished children. This risk also decreased by almost 42% in children receiving iron supplement. CONCLUSION:In consideration to the fact that anemia is a prevalent disease in the Lebanese childhood population, especially in infancy, simple preventive measures such as proper nutritional habits and supplementation of iron rich food to children are highly recommended and should be respected by public health providers.

Many studies have assessed the implication of cluster of differentiation 14 (CD14) molecules and its single nucleotide polymorphism rs2569190A>G with different complex diseases, such as diabetes and cardiovascular diseases (CVDs). In this study, we investigated the association of rs2569190A>G in CD14 with cardiovascular disease risk factors (hypercholesterolemia and hypertension) in 460 individuals from the general Lebanese population (Middle Eastern multiethnic population). Using a multiple logistic regression model adjusted for six covariates (under additive and recessive assumptions), we found that the G allele of rs2569190 in CD14 was associated with increased levels of total cholesterol (OR = 3.10, p = 0.009), low-density lipoprotein cholesterol (OR = 3.87, p = 0.003), and decreased levels of high-density lipoprotein cholesterol (OR = 0.38, p = 0.001). In contrast, no significant relationship was found with hypertension. Thus, we concluded that rs2569190G in CD14 is associated with a higher risk of developing hypercholesterolemia.

Background and Objectives: Four single nucleotide polymorphisms (SNPs); rs6921438 and rs4416670 in LOC100132354-C6orf223, rs6993770 in ZFPM2, and rs10738760 in VLDLR-KCNV2 were reported to explain up to 50% of the heritability of vascular endothelial growth factor circulating levels. These SNPs were also studied for possible associations with circulating lipid levels in supposedly healthy European individuals and in a limited number of Iranian individuals with metabolic syndrome. To go further, the association of those four SNPs with plasma lipid parameters, hypercholesterolemia and metabolic syndrome (MetS) was assessed. Materials and Methods: A cross-sectional study was conducted on 460 individuals chosen from the general population. Demographic and clinical data were collected and DNA was extracted and genotyped using Kompetitive allele specific PCR (KASP™). A meta-analysis followed, combining our participants with the Iranian individuals (n = 336). Results: Whereas rs10738760 was associated with total cholesterol (Tchol) (p = 0.01), rs6993770 showed significant associations with both Tchol and low-density lipoprotein cholesterol (LDL-C) levels (p = 0.007 and p = 0.01 respectively). Using a multivariate logistic regression model adjusted for different confounding factors, we found that rs6993770 was associated with hypercholesterolemia, specifically high Tchol (p = 0.01) and LDL-C levels (p = 0.01). Furthermore, rs10738760 was positively associated with the risk of MetS in these individuals (p = 0.02) and in the meta-analysis (OR = 1.67, p = 0.01). Conclusion: Our results suggest that whereas rs6993770 in ZFPM2 was positively associated with hypercholesterolemia, rs10738760 (VLDLR-KCNV2) has a possible implication in MetS in two Middle Eastern populations.

Hypertension is highly prevalent among the Lebanese adult population and is indeed the major cause of mortality in Lebanon. Traditional use of antihypertensive medicinal plants has long been practiced. The aim of this study is to document this traditional knowledge and clinically test the antihypertensive capacity of three of the most commonly used wild plant species Mentha longifolia, Viola odorata and Urtica dioica. Ethno-pharmacological data was collected by personal interviews with herbalists and traditional healers using a semi structured survey questionnaire and assessing relative frequency of citation (RFC). The clinical study was conducted by a randomized, blind, placebo-controlled trial in 29 subjects with mild hypertension distributed in four groups, three plant extract treatments and one placebo. Systolic (SBP) and diastolic blood pressures (DBP) as well as mean arterial blood pressures (MAP) were monitored at weeks 4, 8, 12 and 16 during the treatment with 300 mL/day of plant extract. Results showed that M. longifolia, U. dioica and V. odorata exhibited the highest values of RCF (0.95) followed by Allium ampeloprasum (0.94), Apium graveolens (0.92) and Crataegus azarolus (0.90). The clinical trial revealed dose- and duration-dependent significant reductions in SBP, DBP and MAP of subjects treated with M. longifolia, U. dioica or V. odorata. Our findings indicate that extracts of these plants present an effective, safe and promising potential as a phyto-therapuetical approach for the treatment of mild hypertension. More research on the phytochemistry, pharmacological effects and the underlying mechanisms is necessary.