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Biomedical subjects

A M Sibai

Publications and source records attributed to A M Sibai.

13 recordsLinked to original sources
PubMed2007

Religiosity and depression in older people: evidence from underprivileged refugee and non-refugee communities in Lebanon.

Religiosity is an important aspect of the life of older people, particularly in the Arab region where religiosity is an important part of daily social and political life. Studies have documented the relationship between religiosity and depression among older people, but none in the region. A total of 740 persons aged 60 + were interviewed in three poor urban areas of Lebanon, one of which was a Palestinian refugee camp. The questionnaire included five items on religiosity covering organizational and intrinsic religiosity. Depression was assessed using the 15-item Geriatric Depression Score (GDS-15). Depression was prevalent in 24% of the older persons interviewed with the highest proportion being from the Palestinian refugee camp (31%). Results suggest that only organizational religiosity was related to depression and this pattern was only significant among the refugee population. Religious practice is discussed as an indicator of social solidarity rather than an aspect of religiosity. Minority groups may rely on religious stratagems to cope with their distress more than other groups.

Aged↗
PubMed2005

Anterior ischaemic optic neuropathy after coronary artery bypass graft: the role of anaemia in diabetics.

PURPOSE: To ascertain factors associated with anterior ischaemic optic neuropathy (AION) following coronary artery bypass graft (CABG) in a Lebanese population. METHODS: A retrospective chart review of consecutive CABG performed over a 5-year period (1995-1999) in one medical centre. A comparison of clinical characteristics was carried out between AION cases and subjects free from AION. The variables analysed included history of diabetes as well as preoperative, intraoperative, or postoperative values of haematocrit, blood sugar, oxygen saturation, and arterial blood pressure. RESULTS: A total of 1,594 persons were included. Three subjects experienced acute visual loss from AION following CABG, all had diabetes mellitus, and two suffered from severe postoperative anaemia. Among diabetics (n=484), the risk of AION was significantly higher in subjects with postoperative haematocrit falling below 22 (28.6%) than the rest (0.21%) (P=0.001). Blood transfusion was given in two subjects with prompt visual recovery. CONCLUSIONS: Severe anaemia in patients undergoing CABG appears to be a risk factor for AION, especially in diabetics, and needs prompt correction to prevent or reverse the ischaemic ocular events.

Aged↗
PubMed2001

Variations in the impact of long-term wartime stressors on mortality among the middle-aged and older population in Beirut, Lebanon, 1983--1993.

The authors investigated the relation between exposure to wartime events and cardiovascular disease (CVD) and all-cause mortality in Lebanon, which recently underwent a 16-year civil war. The study population comprised a representative cohort (n = 1,786) of middle-aged and older men and women who, in 1983, participated in a community-based health interview survey. In 1993, the authors traced 87.7 % of the original cohort (n = 1,567) and assessed their vital status, exposure to war-related events, and, in case they had died, cause of death. War experiences were aggregated into different clusters according to type of exposure, realm affected (human vs. property losses), and person central to the event. Women, but not men, had a significantly elevated CVD mortality risk for exposures to human traumas that occurred to them (rate ratio = 3.37, 95% confidence interval: 1.41, 8.05) or their families (rate ratio = 1.45, 95% confidence interval: 1.20, 1.74). Exposure to property losses and work-related problems carried a greater mortality risk for men, particularly those with lower levels of education, than for women. Subjects displaced during the war had a significantly higher risk for CVD and total mortality. These results suggest that, during prolonged wars, different elements of exposures have a long-term impact on mortality, with effects varying by gender and socioeconomic resources.

Aged↗
PubMed2001

Non-communicable disease mortality rates using the verbal autopsy in a cohort of middle aged and older populations in Beirut during wartime, 1983-93.

STUDY OBJECTIVES: Health priorities in middle to low income countries, such as Lebanon, have traditionally been assumed to follow those of a "typical" developing country, with a focus on the young and on communicable diseases. This study was carried out to quantify the magnitude of communicable and non-communicable disease mortality and to examine mortality pattern among middle aged and older populations in an urban setting in Lebanon. DESIGN AND PARTICIPANTS: A representative cohort of 1567 men and women (>/=50 years) who had participated in a cross sectional multi-dimensional health survey in Beirut, Lebanon in 1983 and were followed up 10 years later. Vital status was ascertained and causes of death were obtained through verbal autopsy. RESULTS: Total mortality rates were estimated at 33.7 and 25.2/1000 person years among men and women respectively. In both sexes, the leading causes of death were non-communicable, mainly circulatory diseases (60%) and cancer (15%). For all cause mortality, men had significantly higher risk than women (age adjusted rate ratio, RR=1.42, 95% confidence intervals (CI) = 1.16, 1.72) especially at younger ages. Except for cerebrovascular diseases, renal problems and injuries attributable to falls and fractures, men were also at higher cause specific mortality risk than women, in particular, for ischaemic heart disease (RR = 2.24, 95% CI = 1.62, 3.12). Comparison with earlier death certificate data in Lebanon and current estimates from other regions in the world showed the magnitude of cardiovascular disease over time. CONCLUSIONS: The results from this first cohort study in the Arab region show, in contrast with popular perception, a mortality pattern more like a developed country than a developing one. Strategies of public health activities, in particular for countries in transition, need to be continuously re-assessed in light of empirical epidemiological data and other health indicators for evidence-based decision making.

Age Distribution↗
PubMed1992

The general practitioner in Lebanon: is he a potential family physician?

A cross-sectional exploratory study was conducted on a group of general practitioners in Beirut, Lebanon to assess the level of family medicine practice among them. Data were collected on the age, sex, number of children, marital status, load of patients per day, field of specialization, if any, and place of study of medicine of 43 general practitioners. The level of family medicine practice was assessed through a self-administered questionnaire containing questions related to the various criteria of family medicine practice. Only 2.3% of the general practitioners had an adequate level of family medicine practice, defined as the top 15th percentile of a maximal score. Doctors were most likely to adhere to the 'informality' criterion and less likely to adhere to the 'family approach', 'ensuring maximal compliance' and 'comprehensiveness of care' criteria. They performed poorly on 'the continuity of care' and on 'the art of medical care' criteria. Overall, family medicine was found not to be adequately practised by the general practitioner and is deemed necessary as a specialty in Lebanon. Suggestions and future recommendations are further presented.

Adult↗
PubMed1992

The impact of civil disturbances on the migration of physicians: the case of Lebanon.

This report examines the impact of war on the migratory patterns of physicians in Lebanon, a country with ever-raging civil disturbances for the past 15 years. The data base included two cohorts of medical graduates of the American University of Beirut: the 1960 through 1969 cohort, whose education and training were completed before the onset of the civil war, and the 1970 through 1979 cohort, who was exposed to the turmoil in Lebanon during either their study or their residency training. Between- and within-cohort comparison of their locations 5 years after graduation was made. Findings suggest that there is an association between civil instability and migration. This relationship could not be explained by possible confounders like nationality, training abroad, and board certification. On the contrary, factors that potentiated migration in the earlier cohort before the onset of the war were less frequent in the latter cohort with the increased tendency to migrate.

Career Choice↗
PubMed1991

Comparison of flumazenil with aminophylline to antagonize midazolam in elderly patients.

We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA I-II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg-1 i.v. and the test drugs were given 5 min after its administration. Patients were allocated randomly to receive i.v. flumazenil 0.01 mg kg-1, aminophylline 2 mg kg-1 or placebo saline 0.1 ml kg-1. One minute after administration, aminophylline caused 42% reversal of sedation, 66% of disorientation and 73% of lack of co-operation in comparison with placebo, although there was marked individual variation. Flumazenil caused complete and rapid antagonism of sedation, disorientation and lack of cooperation.

Aged↗
PubMed1991

Wartime determinants of arteriographically confirmed coronary artery disease in Beirut.

This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for ever a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched on age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases (greater than or equal to 70% maximal stenosis) were compared with two control groups: arteriographic controls (entirely normal coronaries) and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls (odds ratio (OR) = 2.4, 95% confidence interval (CI) 1.17-4.90) and arteriographic controls (OR = 2.8, 95% CI 0.93-8.47). Crossing the "green-lines" that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls (OR = 3.25, 95% CI 1.54-6.89) and arteriographic controls (OR = 5.38, 95% CI 1.65-17.6). The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings.

Adult↗
PubMed1989

Wartime determinants of arteriographically confirmed coronary artery disease in Beirut.

This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for over a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched on age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases (greater than or equal to 70% maximal stenosis) were compared with two control groups: arteriographic controls (entirely normal coronaries) and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls (odds ratio (OR) = 2.4, 95% confidence interval (Cl) 1.17-4.90) and arteriographic controls (OR = 2.8, 95% Cl 0.93-8.47). Crossing the "green-lines" that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls (OR = 3.25, 95% Cl 1.54-6.89) and arteriographic controls (OR = 5.38, 95% Cl 1.65-17.6). The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings.

Adult↗
PubMed1988

Differential lung ventilation during thoracotomy.

The effect of differential lung ventilation on arterial PO2 and PCO2 was compared to that achieved during one-lung ventilation in 8 patients undergoing thoracotomy. In all patients, OLV of the dependent lung, while collapsing the nondependent lung, was associated with lowering of the arterial PO2. DLV using a special double-lumen tube adaptor was then initiated; the dependent lung was preferentially ventilated by 75-80% of the tidal volume, while the nondependent lung on the operative side was only ventilated by 20-25% of the tidal volume. DLV improved oxygenation and maintained adequate carbon dioxide elimination, with minimal inflation of the nondependent lung into the surgical field. DLV may be used to increase oxygenation whenever conventional OLV is associated with hypoxemia despite the use of 100% oxygen.

Adult↗