Rabih Hallit

Correlation of Types of Food and Asthma Diagnosis in Childhood: A Case-Control Study

ABSTRACT Objective: Studies concerning asthma in Lebanon investigated environmental and personal factors but none of them took into account the effect of nutritional habits. Our objective is to assess the effect of nutritional habits on asthma and allergies in Lebanese children aged 3–16 years old. Methods: This is a case–control study, conducted between December 2015 and April 2016. The Food Frequency Questionnaire was composed of 16 semi-quantitative questions covering different food categories. Results: This study included 1,276 children (976 healthy and 300 asthmatic children). Eating dairy products less than twice a week, 3–6 times per week and daily were significantly and inversely associated with asthma, as compared to never eating dairy products (p = 0.02, ORa = 0.285, CI 0.099–0.821; p < 0.001, ORa = 0.140, CI 0.052–0.378 and p < 0.001, ORa = 0.161, CI 0.061–0.422), whereas eating red meat daily compared to never was associated with asthma significantly (p = 0.037, ORa = 2.051, CI 1.046–4.024). Eating nuts less than twice weekly as compared to never was significantly and inversely associated with asthma (p = 0.035, ORa = 0.597, CI 0.369–0.965). The age categories 7–10 and 11–13 years were significantly associated with asthma as compared to the 3–6 years category (p < 0.001, ORa = 3.359, CI 1.869–6.038 and p = 0.008, ORa = 2.191, CI 1.228–3.909, respectively), while male gender was significantly more prone to asthma (p = 0.014, ORa = 0.686, CI 0.507–0.926). Conclusions: Knowing the correlation between nutritional habits and asthma is important to promote healthy eating. Educational programs for parents about healthy food and breastfeeding encouragement is warranted.

AIDS-Related Lymphoma: Resolution with Antiretroviral Therapy Alone

Patients with HIV are at increased risk of malignancy, particularly lymphoma, which is the most common malignancy leading to death. With the advent of highly active antiretroviral therapy (HAART), patients live longer but have a longer duration of antigenic stimulation, increasing the prevalence of AIDS-related lymphoma (ARL) in the population living with HIV. Highly active antiretroviral therapy plays a direct role in preserving the immune system, helping to decrease the incidence of ARL. We present a case of a female patient with HIV (CD4 count of 576 cells/mm3) diagnosed with a stage III-B non-Hodgkin lymphoma in 2009 while off HAART. She was subsequently started on HAART, leading to full resolution of her lymphoma without any chemotherapeutic intervention. She was last seen in the clinic in December 2013 without any evidence of recurrence of her lymphoma. To our knowledge, this is the first case report of a stage III-B non-Hodgkin lymphoma in an HIV-infected patient, which resolved with only HAART.

An Arabic Version of the Geriatric Depression Scale (30 Items): Psychometric Properties and Some Findings in a Lebanese Elderly Sample

Background/Aim: Although the rates of depression and anxiety disorders have been shown to be higher in older people, especially those living in institutional settings, most of this population remains undiagnosed and untreated. The objective is to translate the full-scale Geriatric Depression Scale (30 items, GDS) into Arabic for use in elderly patients in Lebanon, to check its validity and reproducibility in comparison to the original version of the questionnaire, and assess the risk factors associated with depression in the Lebanese geriatric population. Methods: This case-control study was conducted between June and August 2016 and included 500 patients aged more than 60 years (250 living inside and 250 outside a nursing home). Results: Strongly positive correlations (p < 0.001 for all items of the scale) were found between each item of the scale and the total scale. The mean inter-item correlation for our scale was 0.51, higher than that of the original scale (0.36), with an excellent internal consistency (Cronbach α = 0.901). Living in a nursing home, stress, anxiety, being married, age, and the primary level of education would significantly increase depression (β = 2.211, β = 0.223, β = 0.041, β = 0.902, β = 0.118, and β = 3.533, respectively). A normal nutritional status and a university level of education would significantly decrease depression (β = –0.732; β = –1.961). Conclusion: The Arabic version of the GDS can be used to estimate the severity of depression in the Lebanese elderly population. Periodic screening for anxiety, nutritional status, and stress is also recommended among geriatric people living in Lebanon.

Validation of the mini pediatric asthma quality of life questionnaire and identification of risk factors affecting quality of life among Lebanese children

ABSTRACT Background: Few studies used various scales to assess the QOL in Lebanon in general but none was specific to asthma. Our objective was to assess the asthma-related quality of life, using the mini Pediatric Asthma Quality of Life Questionnaire (PAQLQ), in Lebanese asthmatic children, check its validity compared to the original version, and identify clinical and sociodemographic risk factors that might affect these childrens QOL. Methods: This retrospective study included 300 children aged between 7–16 years (51.6% boys and 48.4% girls). To confirm the mini-PAQLQ questionnaire construct validity in the Lebanese population, an exploratory factor analysis was launched for the 13 items of the questionnaire, using the principal component analysis technique. Cronbachs alpha was recorded for reliability analysis. A multivariate analysis linear regression was carried out, taking the QOL score as the dependent variable. Results: The correlation coefficients for factors 1 (symptoms and emotions) and 2 (activities) were similar to that of the original scale. High Cronbachs alphas were found for factor 1 (0.914), factor 2 (0.888), and the full scale (0.921). Uncontrolled asthma, the childs respiratory problems before the age of 2 years, and the presence of pets at home significantly decreased the childrens asthma-related quality of life (Beta = −1.541; Beta = −6.846, and Beta = −5.364, respectively). Conclusion: We were able to validate the mini-PAQLQ among the Lebanese population. The identification of risk factors, some of which are amenable to intervention, especially uncontrolled asthma, could lead to an improvement in the asthmatic childrens QOL.

The AAA Risk Factors Scale: A New Model to Screen for the Risk of Asthma, Allergic Rhinitis and Atopic Dermatitis in Children

Objective: To create an allergic disease risk factors scale score that would screen for the risk assessment of asthma, allergic rhinitis and atopic dermatitis (AD) in children from 3 to 17 years. Methods: This case-control study, conducted between December 2015 and April 2016, enrolled 1,274 children. The allergic disease risk factors scale was created by combining environmental, exposure to toxics during pregnancy and breastfeeding and parental history of allergic diseases. Results: Playing on carpets, male gender, child’s respiratory problems or history of eczema before the age of 2 years, and humidity significantly increased the odds of allergies in the child. Maternal waterpipe smoking, maternal history of rhinitis, history of asthma in the mother or the father, along with the maternal drug intake or alcohol consumption during pregnancy significantly increased the odds of allergies in the child. There was a significant increase in allergy diseases per category of the allergic disease risk factors scale (p < 0.001 for trend). Scores ≤2.60 best represented control individuals, while scores > 5.31 best represented children with allergic diseases. Conclusion: Allergic diseases seem to be linked to several risk factors in our population of school children. Many environmental factors might be incriminated in these allergic diseases.

Effect of exclusive cigarette smoking and in combination with waterpipe smoking on lipoproteins

Objective: A significant increase in total cholesterol and LDL-C is well shown in tobacco users, as compared to non-tobacco users. The additive effects of waterpipe and cigarette smoking on LDL levels have not been studied. The study’s objective was to assess the correlation between cigarette smoking and LDL levels in Lebanese cigarette smokers and to check the interaction effect of waterpipe and cigarette smoking on LDL levels. Methods: This cross-sectional study was conducted between October 2016 and February 2017 in 4 different laboratories, enrolling 308 patients (188 non-smokers, 105 cigarette smokers, 15 previous smokers). Results: Current cigarette smoking (Beta = 25.57; p < 0.0001) was significantly associated with higher LDL levels and higher total cholesterol levels (Beta = 53.29; p < 0.0001) in exclusive cigarette smokers. Among current cigarette smokers who were current waterpipe smokers, a significant increase in LDL level was observed relative to current cigarette smokers who were not waterpipe smokers (Beta = 66.64 vs Beta = 37.37; p < 0.0001). Conclusion: Among Lebanese current cigarette smokers, LDL levels increased relative to nonsmokers, consistent with findings in other populations. In addition, among Lebanese current cigarette smokers, current waterpipe smoking might increase adverse lipid profiles associated with adverse coronary effects more than cigarette smoking alone. The direct cause responsible for these observed variations in our study remains unidentified, with the hope that future research will reveal it.