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Abstract: A total number of 300 (225 ducks and 75 drakes) Sudani ducks, 28-wk-old were divided into five groups to investigate the effects of dietary L-carnitine (LC) supplementation on productive, hatching and physiological performance as well as nutrients digestibility coefficients. The results indicated that the productive performance and Semen quality parameters (ejaculate volume, sperms concentration and advanced motility) were significantly improved by LC supplementation (150-450 mg /kg diet) as compared to the control. Hatchability of fertile eggs (%) was significantly improved, while total embryonic mortality was significantly decreased by supplementing 300 and 450 mg LC/kg diet. Supplementing different dietary LC levels resulted in significantly high values of hemoglobin, red and white blood cells count and lymphocyte (L) cells percentage, while it decreased heterophils (H) cells and H/L ratio. Serum albumin, total cholesterol and AST enzyme values were significantly low in ducks fed diets supplemented with LC. Serum triglycerides were significantly the lowest by feeding 300 and 450 mg LC/kg diet. Nutrients digestibility coefficients were significantly improved in drakes fed diet supplemented with 450 mg LC/kg diet. Conclusively, dietary LC supplementation at 300 or 450 mg/kg for duck breeders in summer could improve productive, hatching and physiological performance and nutrients digestibility coefficients.

Maria J Abou El-Ola,1 Mariam A Rajab,2 Dania I Abdallah,3 Ismail A Fawaz,4 Lyn S Awad,5 Hani M Tamim,6 Ahmad O Ibrahim,7 Anas M Mugharbil,7 Rima A Moghnieh8 1Department of Obstetrics and Gynaecology, Makassed General Hospital, Beirut, Lebanon; 2Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon; 3Department of Pharmacy, Makassed General Hospital, Beirut, Lebanon; 4Department of Internal Medicine, Iklim Health Foundation Hospital, Mazboud, Mount Lebanon, Chouf, Lebanon; 5Department of Pharmacy, Makassed General Hospital, Beirut, Lebanon; 6Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; 7Division of Hematology/Oncology, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon; 8Division of Infectious Diseases, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon Background: Human papillomavirus (HPV) infection is an established predisposing factor of cervical cancer. In this study, we assessed the awareness about genital warts, cervical cancer, and HPV vaccine among mothers having girls who are at the age of primary HPV vaccination attending a group of schools in Lebanon. We also assessed the rate of HPV vaccination among these girls and the barriers to vaccination in this community. Subjects and methods: This is a cross-sectional, school-based survey. A 23-item, self-administered, anonymous, pretested, structured questionnaire with closed-ended questions was used to obtain data. The questionnaire was sent to the mothers through their student girls, and they were asked to return it within a week. Data were analyzed using the Statistical Package for Social Sciences version 21.0. Bivariate analysis was performed using the chi-square test to compare categorical variables, whereas continuous variables were compared using the Student’s t-test. Fisher’s exact test was used when chi-square test could not be employed. Results: The response rate in our survey was 39.4%. Among the responders, the rate of awareness about HPV infection was 34%, where 72% of the mothers had heard about cervical cancer, and 34% knew that a vaccine is available to prevent cervical cancer. HPV vaccination uptake rate was 2.5%. This lack of vaccination was primarily attributed to the low rate of mothers’ awareness about the vaccine (34%). Factors significantly affecting awareness about the vaccine were the mothers’ marital age, nationality, level of education, employment, and family income. Barriers to HPV vaccination, other than awareness, were uncertainty about safety or efficacy of the vaccine, conservative ideas of mothers regarding their girls’ future sexual life, and relatively high price of the vaccine. Conclusion: Vaccine uptake is low among eligible girls attending this group of schools. The barriers to vaccination are multiple; the most important one is the mothers’ lack of knowledge about HPV, cervical cancer, and the modes of prevention. Awareness campaigns along with a multimodal strategy that targets the identified barriers would be recommended to achieve higher rates of HPV vaccination. Keywords: awareness, barriers, cervical cancer, human papillomavirus, knowledge, Lebanon, mothers, schools, vaccine

Lyn S Awad,1,* Dania I Abdallah,1,* Anas M Mugharbil,2,3 Tamima H Jisr,2,4 Nabila S Droubi,1 Nabila A El-Rajab,5 Rima A Moghnieh2,6,7 1Pharmacy Department, Makassed General Hospital, 2Faculty of Medicine, Beirut Arab University, 3Department of Internal Medicine, Division of Hematology-Oncology, 4Department of Laboratory Medicine, 5Department of Internal Medicine, 6Department of Internal Medicine, Division of Infectious Diseases, Makassed General Hospital, 7Department of Internal Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon *These authors contributed equally to this work Introduction: Management of ventilator-associated pneumonia (VAP), the most common infection in patients on mechanical ventilation, should be tailored to local microbiological data. The aim of this study was to determine susceptibility patterns of organisms causing VAP to develop a treatment algorithm based on these findings and evidence from the literature. Materials and methods: This is a retrospective analysis of the microbiological etiology of VAP in the intensive care unit (ICU) of a Lebanese tertiary care hospital from July 2015 to July 2016. We reviewed the latest clinical practice guidelines on VAP and tried to adapt these recommendations to our setting. Results: In all, 43 patients with 61 VAP episodes were identified, and 75 bacterial isolates caused VAP. Extensively drug-resistant (XDR) Acinetobacter baumannii was the most common organism (37%), and it had occurred endemically throughout the year. Pseudomonas aeruginosa was the next most common organism (31%), and 13% were XDR. Enterobacteriaceae (15%) and Stenotrophomonas maltophilia (12%) shared similar incidences. Our algorithm was based on guidelines, in addition to trials, systematic reviews, and meta-analyses that studied the effectiveness of available antibiotics in treating VAP. Conclusion: Knowing that resistance can rapidly develop within a practice environment, more research is needed to identify the best strategy for the management of VAP. Keywords: ventilator-associated pneumonia, Pseudomonas aeruginosa, Acinetobacter baumannii, local epidemiology, carbapenem-sparing strategy, guidelines

Serum antibody titres to Adenovirus, Chlamydia Group B, , Cytomegalovirus, virus, Influenza A, Influenza B, Measles and were measured in 33 patients with a clinical diagnosis of Alzheimer's disease, and in 28 non-demented controls suffering from functional psychiatric disorders. No statistically significant differences were found between the patients and controls, and it is concluded that these agents play no role in the aetiology of Alzheimer's disease. [ABSTRACT FROM PUBLISHER]