Sustaining compliance with hand hygiene when resources are low: A quality improvement report.

Background: Sustainability of hand hygiene is challenging in low resource settings. Adding ownership and goal setting to the WHO-5 multimodal intervention may help sustain high compliance.

Aim: To increase and sustain compliance of nursing and medical staff with hand hygiene in a tertiary referral center with limited resources.

Spirituality among parents of children with cancer in a Middle Eastern country.

Purpose: Family caregivers of children with cancer face emotional, psychological, and spiritual challenges coping with their child's illness. For ensuring comprehensive multidisciplinary pediatric care, there is a need to understand and define what spirituality means for them in relation to their child's illness. The purpose of this study is to understand the meaning of spirituality for parents of cancer patients in Lebanon.

The lived experience of parents of children admitted to the pediatric intensive care unit in Lebanon.

Background: Family caregivers have a significant responsibility in the care of their child in the Pediatric Intensive Care Unit (PICU). Parents staying with their child in the PICU have particular needs that should be acknowledged and responded to by clinicians. Several studies have been conducted in the USA and Europe to try to understand the experience of family caregivers of children admitted to the Pediatric Intensive Care Unit.

Epilepsy surgery in a developing country (Lebanon): ten years experience and predictors of outcome.

We present our 10-year experience and preoperative predictors of outcome in 93 adults and children who underwent epilepsy surgery at the American University of Beirut. Presurgical evaluation included video-EEG monitoring, MRI, neuropsychological assessment with invasive monitoring, and other tests (PET, SPECT, Wada). Surgeries included temporal (54%), extratemporal (22%), and multilobar resections (13%), hemispherectomy (4%), vagal nerve stimulation (6%), and corpus callosotomy (1%).

Profile of injured patients presenting to a tertiary hospital in a developing country.

Background: In most developing countries including Lebanon, trauma research is lacking and warranted. Objectives of the current study were to describe trauma patients referred to a tertiary care center during one year and identify outcomes and patterns of injury.

Methods: Review of hospital charts of every 12th consecutive patient presenting to the emergency unit (ED) after a traumatic event during the year 2001-2002.

Common dermatologic diseases among students at a tertiary care center in Lebanon.

Unlabelled: There are few publications on prevalence of skin diseases in Lebanon.

Objectives: To find the prevalence of dermatologic diseases among students seen at the university health services of the American University of Beirut.

Patients & Methods: Medical charts were retrospectively reviewed.

Quality of life after surgery for intractable partial epilepsy in children: a cohort study with controls.

Purpose: Investigate if quality of life (QOL) normalizes on long-term follow-up after surgery for partial epilepsy in children.

Methods: This is a cohort study with controls in which a consecutive cohort of nineteen 2-14-year-old children who underwent focal resections for intractable partial seizures between 1996 and 2006, were matched with 19 non-surgery intractable partial epilepsy patients, and with 19 healthy subjects. The two epilepsy groups were matched for age, sex, socio-economic status (SES), cognitive level, seizure type, and seizure frequency.

Electroencephalographic changes in pyridoxine-dependant epilepsy: new observations.

Objective: Pyridoxine-dependent epilepsy (PDE) is a rare disease, of which the EEG manifestations are only partially characterised. We report our observations of EEG recordings in four patients with PDE.

Materials And Methods: EEG tracings from four patients fulfilling the clinical criteria for PDE were reviewed.

Intravenous immunoglobulin therapy in intractable childhood epilepsy: open-label study and review of the literature.

Our aim was to investigate the long term effectiveness of intravenous immunoglobulin (IVIG) against intractable childhood epilepsy in the era of new antiepileptics and to determine the predictors of a favorable response in a prospective open-label add-on study. Of thirty-seven 9.9+/-0.

Determinants of university students physical exercise: a study from Lebanon.

Background: Studies to assess the patterns of physical exercise among University students in Lebanon are lacking. The current study looks at the prevalence of physical exercise among university students in Beirut and predictors of performing physical exercise.

Methods: In a cross-sectional study, a proportionate random sample of university students selected from five major universities were asked to complete a self-administered questionnaire related to physical exercise, demographic, scholastic, and health risk behavioral characteristics.

Approach to pediatric epilepsy surgery: State of the art, Part I: General principles and presurgical workup.

In 1990, the National Institute of Health adopted epilepsy surgery in children as an option when medications fail. In the past few years several concepts have become increasingly recognized as key to a successful approach to epilepsy surgery in children. These include the concepts of neuronal plasticity, the epileptogenic lesion, the ictal onset, symptomatogenic, irritative, and epileptogenic zones.

Approach to pediatric epilepsy surgery: State of the art, Part II: Approach to specific epilepsy syndromes and etiologies.

The second of this 2-part review depicts the specific approach to the common causes of pediatric refractory epilepsy amenable to surgery. These include tumors, malformations due to abnormal cortical development, vascular abnormalities and certain epileptic syndromes. Seizure freedom rates are high (usually 60-80%) following tailored focal resection, lesionectomy, and hemispherectomy.

Health care workers' exposure to blood-borne pathogens in Lebanon.

Background: Accidental exposure to blood-borne pathogens (BBPs) is a risk for health care workers (HCWs).

Aim: To study the pattern of occupational exposure to blood and body fluids (BBFs) at a tertiary care hospital.

Methods: This study reports a 17-year experience (1985-2001) of ongoing surveillance of HCW exposure to BBFs at a 420-bed academic tertiary care hospital.

Sickness-related absence among employees at a tertiary care center in Lebanon.

The authors studied the rate of sickness-related absence of employees at a tertiary care center. They examined sickness-related absence records of employees, including nurses, food service workers, housekeeping, and security personnel, in a university teaching hospital in Lebanon over a period of 1 year. These departments included 1,010 employees, of which 47% took sickness absences during the study period.

Novel mutation causing partial biotinidase deficiency in a Syrian boy with infantile spasms and retardation.

We report a case of partial biotinidase deficiency (plasma biotinidase levels: 1.30 nm/minute/mL) in a 7-month-old boy who presented with evidence of perinatal distress followed by developmental delay, hypotonia, seizures, and infantile spasms without alopecia or dermatitis. His neurologic symptoms improved markedly on biotin supplementation and antiepileptic drug therapy.

A suggested clinical score to predict the severity of adenoid obstruction in children.

Chronic nasal obstruction in children is a very common disorder. Obstructing adenoid is usually the first to blame. Though the clinical assessment is essential, it is often considered unreliable or insufficient.

Normalization of quality of life three years after temporal lobectomy: a controlled study.

Purpose: The goal of epilepsy surgery is not merely to control previously intractable seizures, but also to improve quality of life (QOL). Our goals were to assess, in our Middle Eastern population, the QOL of adults with temporal lobe epilepsy (TLE) 3 years after temporal lobectomy as compared with matched TLE patients who did not undergo surgery and with healthy individuals in the same community.

Methods: Twenty consecutive TLE patients who underwent temporal lobectomy 3 years previously were matched in the following variables: age, sex, seizure frequency, seizure duration, age at onset of epilepsy, duration of epilepsy, and number of medications, with 17 TLE patients who underwent the presurgical evaluation and subsequent optimization of medical therapy but did not undergo surgery.

Risky weight control among university students.

Objective: The objectives of the current study were to investigate risky weight control measures (vomiting or pills) among university students in Lebanon and to assess their relation to demographic, scholastic, and health risk behavioral characteristics.

Method: The study used a cross-sectional design. A proportionate random sample of 2,013 students was selected from public and private universities in Greater Beirut.

Febrile seizures. From molecular biology to clinical practice.

Febrile seizures occur between the age of 3 months and 5 years with a temperature of 38 degrees C or higher, and are either simple or complex. Eight gene loci have been identified to be associated with certain cases of autosomal dominant familial febrile seizures, and 12 genes have been associated with some of the familial epilepsy syndromes that can start with febrile seizures. The mutations and the protein products are known for only some of these 20 genes.

Outbreak of Burkholderia cepacia bacteremia traced to contaminated hospital water used for dilution of an alcohol skin antiseptic.

Objective: To identify the source of an epidemic of Burkholderia cepacia bloodstream infections during 7 years (411 episodes in 361 patients).

Design: Outbreak investigation.

Setting: A 250-bed university hospital in Beirut, Lebanon.

Effects of epilepsy surgery on quality of life: a controlled study in a Middle Eastern population.

The purpose of this study was to investigate which areas of quality of life (QOL) change after epilepsy surgery and generate QOL data specific to the Lebanese population. The QOL of 20 consecutive patients 1 year after surgery was compared (using the ESI-55 scale) with that of 20 matched patients who underwent the same presurgical evaluation, but no surgery. Overall QOL improved in both groups, but was greater in the surgery group (85% seizure free as compared to 0% in nonsurgery group).