From the Editor
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Ahmad Husari
Editor, Middle-East Journal of Internal Medicine
Director, American University of Beirut Sleep Disorders Center
Director, American University of Beirut outpatient clinical care services
Assistant Professor
Division of Pulmonary and Critical Care Medicine
American University of Beirut Medical Center
Beirut Lebanon
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This is the third issue this year that is rich with papers from the region dealing with various topics. A case- control study from Jordan was designed to assess the relation between maternal anaemia in the third trimester and premature birth. A total of 200 women were included in the study and divided into two groups. Maternal anaemia was defined as haemoglobin level < 11g/dL and preterm delivery was defined as delivery prior to 37 weeks of gestation. Patients with haemoglobinopathies, systemic diseases. It was observed that maternal anaemia in the third trimester, at labour, was associated with an increased risk of prematurity.

Helvaci et al tried to understand whether or not there is a significant relationship between cholelithiasis or cholecystectomy and plasma lipids. One hundred and forty-four cases either with cholelithiasis or cholecystectomy for cholelithiasis were included. The authors concluded that there are significant relationships between cholelithiasis and parameters of the metabolic syndrome. Although the significantly lower prevalence of hyperbetalipoproteinemia probably due to the decreased amount of bile acids secreted during entrance of food into the duodenum and decreased amount of cholesterol absorbed in patients with cholelithiasis or cholecystectomy, the higher prevalence of hypertriglyceridemia may actually indicate its primary role as an acute phase reactant in the plasma.

A paper from Turkey, Lebanon and Australia looked at the effect of Triglyceride level on survival. The study included 478 cases (288 females and 190 males). Metabolic syndrome is a chronic inflammatory process mainly affecting the vascular endothelium all over the body and terminating with early aging and premature death. Hypertriglyceridemia may be one of the most significant reversible parameters of the metabolic syndrome, and it is better to have the lowest plasma triglyceride value as much as possible to live longer.

Haddad et al through descriptive study looked out the most common local side effects caused by inhalers in patients with Chronic Obstructive Pulmonary Disease (COPD). The effect of regular mouth rinsing with water after inhaler use in preventing these side effects was evaluated too. The authors concluded that local side effects of inhalers are common among COPD patients treated in KHMC. The most common side effects are throat and vocal complaints. Failure to adhere to mouth rinsing with water after inhaler use plays a major role in increasing the rates of these side effects.

A retrospective study from Yemen of descriptive patterns of findings seen in hysterectomy specimens based on records from Modern - histopathology laboratory in Aden. A total of 2544 specimens were analyzed during the 6 years period, to study the histopathological findings of these specimens. Most common pathology findings are, Endometrial hyperplasia 1481 (58.3%), Non neoplastic cystic lesion 1386 (54.5%), Chronic cervicitis 1363 (53.6%), Adenomyosis 793 (31.2% ) follow by Leiomyoms 697 (27.4%). Other less frequent pathologies identified included atrophic endometrium, Inadequate secretory endometrial transformation, Gestational Trophoblastic disease, Endometroid adenocarcinoma, cervical prolapse. This study confirms that benign pathologies are more common in hysterectomy specimens than their malignant counterparts.

A randomized study from in which 40 patients with recurrent or advanced non-small-cell lung cancer (stage IIIB or IV) received paclitaxel and carboplatin (paclitaxel-carboplatin arm) (20 patients) or paclitaxel and carboplatin in addition to bevacizumab (paclitaxel-carboplatin-bevacizumab arm) (20 patients). The median overall survival was 15.5 months in the paclitaxel-carboplatin-bevacizumab arm as compared with 10.5 months in the paclitaxel-carboplatin arm ( P=0.002). The authors concluded that the addition of bevacizumab to the chemotherapy add a significant value to the patients with non squamous nsclc in terms of response rate, progression free survival and overall survival however with significant side effects.

Helvaci et al investigate the role of Moderate anemia and metabolic syndrome.
Age and sex-matched cases with a hematocrit value of less than 30% were collected into the first, less than 36% into the second, less than 40% into the third, and 40% or greater into the fourth groups. The study included 108 anemia patients. The anemia cases were mainly iron deficiency anemia and/or thalassemia minors. When we compared the first group with the second, the BMI and weight were significantly retarded in the first group (23.6 versus 26.9 kg/m2, p= 0.005 and 61.3 versus 69.9 kg, p= 0.008), whereas there were nonsignificant differences between the second, third, and fourth groups for both (p>0.05 for all). Although the significantly retarded BMI and weight in the first group, body heights were similar in the four groups (p>0.05 for all). The authors concluded that although the BMI and weight can be affected by moderate anemia, the height may strongly be determined by heredity. Since the excess weight may be a significant underlying cause of the metabolic syndrome, and the metabolic syndrome shortens human lifespan significantly, and there is no case with shortened survival due to iron deficiency anemia and/or thalassemia minors, an iatrogenic and moderate iron deficiency anemia with frequent blood donation may prolong human survival by decreasing the BMI and weight in the overweight and obese individuals.