Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_68_21
S. Elmiladi, E. Elgdhafi, A. Shukri
Background: Cardiovascular autonomic neuropathy (CAN) can affect daily activities and patients' quality of life and evoke potentially life-threatening outcomes in diabetes mellitus (DM). Objectives: We aimed to identify and characterize CAN and associated disorders in Libyan patients with DM at National Diabetes Hospital. Patients and Methods: Ninety-nine patients with DM seen in the outpatient clinics from October 2017 to April 2018 at National Diabetes Hospital were prospectively evaluated. Assessments for CAN were made by clinical symptoms and signs, cardiovascular autonomic reflex tests, and echocardiogram. Patients with potentially confounding concomitant medical conditions were excluded. CAN is defined as possible (one abnormal cardiovagal test), confirmed (two abnormal such tests), and severe (with concomitant orthostatic hypotension and heart rate abnormality). Results: Sixty-two percent of the studied patients (mean age: 52 ± 1.5 years, 53% – female) with DM had CAN. CAN diagnosis was possible in 18% of these patients, confirmed in 6%, and severe in 38%. The presence of severe CAN was associated with hypoglycemic unawareness (P = 0.01), dyslipidemia (P = 0.012), and microvascular diabetic complications (P = 0.04). Conclusions: In this cohort of relatively old and high-risk cardiovascular disease, patients with diabetes, uncontrolled blood pressure, associated dyslipidemia, presence of microvascular complication of diabetes, and history of hypoglycemic unawareness were strongly associated with a severe form of cardiac autonomic neuropathy with potentially serious clinical consequences. Larger and more detailed studies are needed to elucidate further the complex association between hypoglycemia and cardiac autonomic dysfunction.
{"title":"Diagnosis, staging, and associated conditions of cardiovascular autonomic neuropathy in Libyan patients with diabetes","authors":"S. Elmiladi, E. Elgdhafi, A. Shukri","doi":"10.4103/ijmbs.ijmbs_68_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_68_21","url":null,"abstract":"Background: Cardiovascular autonomic neuropathy (CAN) can affect daily activities and patients' quality of life and evoke potentially life-threatening outcomes in diabetes mellitus (DM). Objectives: We aimed to identify and characterize CAN and associated disorders in Libyan patients with DM at National Diabetes Hospital. Patients and Methods: Ninety-nine patients with DM seen in the outpatient clinics from October 2017 to April 2018 at National Diabetes Hospital were prospectively evaluated. Assessments for CAN were made by clinical symptoms and signs, cardiovascular autonomic reflex tests, and echocardiogram. Patients with potentially confounding concomitant medical conditions were excluded. CAN is defined as possible (one abnormal cardiovagal test), confirmed (two abnormal such tests), and severe (with concomitant orthostatic hypotension and heart rate abnormality). Results: Sixty-two percent of the studied patients (mean age: 52 ± 1.5 years, 53% – female) with DM had CAN. CAN diagnosis was possible in 18% of these patients, confirmed in 6%, and severe in 38%. The presence of severe CAN was associated with hypoglycemic unawareness (P = 0.01), dyslipidemia (P = 0.012), and microvascular diabetic complications (P = 0.04). Conclusions: In this cohort of relatively old and high-risk cardiovascular disease, patients with diabetes, uncontrolled blood pressure, associated dyslipidemia, presence of microvascular complication of diabetes, and history of hypoglycemic unawareness were strongly associated with a severe form of cardiac autonomic neuropathy with potentially serious clinical consequences. Larger and more detailed studies are needed to elucidate further the complex association between hypoglycemia and cardiac autonomic dysfunction.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"215 - 221"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44625061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_51_21
S. Shrivastava, P. Shrivastava
A successful medical practitioner is not only measured by the knowledge about the subject, ability to apply the learned knowledge, and the skillset, but also by their ability to communicate, empathize, and offer tender care and support to the patients and their caregivers. To prepare the medical practitioner to effectively discharge their roles, it is a must that active interventions are being taken during the period of medical training. In a targeted attempt to strategically bridge the existing gaps, the regulatory body in India has recommended to all the medical colleges to introduce attitude, ethics, and communication (AETCOM) module in the undergraduate training period. However, it is always nice to understand the strengths, weaknesses, opportunities, and threats (SWOT) involved in the implementation of training modules so that the intended learning outcomes can be accomplished in the due course. In conclusion, the decision to systematically introduce and expose the students to AETCOM module is a historical one in the undergraduate training period. It is the need of the hour that every medical institution performs the Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of their own setting and then devises a flexible plan to derive maximum benefit for the students.
{"title":"Ensuring smooth implementation of attitude, ethics, and communication module in medical colleges: SWOT analysis","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/ijmbs.ijmbs_51_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_51_21","url":null,"abstract":"A successful medical practitioner is not only measured by the knowledge about the subject, ability to apply the learned knowledge, and the skillset, but also by their ability to communicate, empathize, and offer tender care and support to the patients and their caregivers. To prepare the medical practitioner to effectively discharge their roles, it is a must that active interventions are being taken during the period of medical training. In a targeted attempt to strategically bridge the existing gaps, the regulatory body in India has recommended to all the medical colleges to introduce attitude, ethics, and communication (AETCOM) module in the undergraduate training period. However, it is always nice to understand the strengths, weaknesses, opportunities, and threats (SWOT) involved in the implementation of training modules so that the intended learning outcomes can be accomplished in the due course. In conclusion, the decision to systematically introduce and expose the students to AETCOM module is a historical one in the undergraduate training period. It is the need of the hour that every medical institution performs the Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of their own setting and then devises a flexible plan to derive maximum benefit for the students.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"222 - 226"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45165035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_72_21
E. Elkhammas
{"title":"Goodbye 2021","authors":"E. Elkhammas","doi":"10.4103/ijmbs.ijmbs_72_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_72_21","url":null,"abstract":"","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"155 - 155"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47648156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_74_21
Nada Fawaris, M. Esaadi, Ali Tumi, Aisha Elhamedi, Ahmed Al Montasir
Gaucher's disease is a rare lysosomal storage disease that can present with a wide range of clinical symptoms according to type and severity, ranging from mild general wellbeing, organomegaly, pancytopenia, neurological symptoms, lung involvement, and even death, making the diagnosis and work up challenging to reach a diagnosis. We report a Libyan Arab female presented with bruises after minor trauma, bone aches, and fatigue. A 35-year-old female from Libyan–Arab ethnicity attended the hematology clinic complaining of bruises after minor trauma, bone aches, and undue fatigability. She mentioned and evident from her medical record that she has been suffering from these complaints for 5 years and does not have any definite diagnosis. Mild splenomegaly was the only finding on clinical examination this time. There was no fever and no lymphadenopathy. Thrombocytopenia with a platelet count 90 × 10 and quot; 3/ml, and splenomegaly of 16 cm was found on investigations. She was diagnosed with cryptogenic thrombocytopenia, and she was advised for a follow-up visit. Our patient attended a follow-up visit twice in the next 18 months with similar complaints of manageable bruising, bone pain, and fatigability. Hematology reports showed thrombocytopenia in each visit. An ultrasonogram of the abdomen revealed a gallbladder stone and spleen have a size of 17 cm. Bone marrow biopsy was done, and a blood test confirmed glucocerebrosidase enzyme deficiency. Considering the diagnosis of Gaucher's disease, treatment with imiglucerase infusion was started. Unfortunately, she failed to continue the treatment due to a shortage of supply of the medication. A few months later, she got pregnant and developed threatened abortion, which ended with a miscarriage. This case illustrates the need to consider this disease in the differential diagnoses when dealing with unexplained thrombocytopenia, anemia, hepatomegaly, and splenomegaly. There are several challenges in the diagnosis and treatment of Gaucher's disease, particularly in resource-limited settings.
{"title":"Challenges in the diagnosis and management of gaucher's disease in a young adult libyan arab female","authors":"Nada Fawaris, M. Esaadi, Ali Tumi, Aisha Elhamedi, Ahmed Al Montasir","doi":"10.4103/ijmbs.ijmbs_74_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_74_21","url":null,"abstract":"Gaucher's disease is a rare lysosomal storage disease that can present with a wide range of clinical symptoms according to type and severity, ranging from mild general wellbeing, organomegaly, pancytopenia, neurological symptoms, lung involvement, and even death, making the diagnosis and work up challenging to reach a diagnosis. We report a Libyan Arab female presented with bruises after minor trauma, bone aches, and fatigue. A 35-year-old female from Libyan–Arab ethnicity attended the hematology clinic complaining of bruises after minor trauma, bone aches, and undue fatigability. She mentioned and evident from her medical record that she has been suffering from these complaints for 5 years and does not have any definite diagnosis. Mild splenomegaly was the only finding on clinical examination this time. There was no fever and no lymphadenopathy. Thrombocytopenia with a platelet count 90 × 10 and quot; 3/ml, and splenomegaly of 16 cm was found on investigations. She was diagnosed with cryptogenic thrombocytopenia, and she was advised for a follow-up visit. Our patient attended a follow-up visit twice in the next 18 months with similar complaints of manageable bruising, bone pain, and fatigability. Hematology reports showed thrombocytopenia in each visit. An ultrasonogram of the abdomen revealed a gallbladder stone and spleen have a size of 17 cm. Bone marrow biopsy was done, and a blood test confirmed glucocerebrosidase enzyme deficiency. Considering the diagnosis of Gaucher's disease, treatment with imiglucerase infusion was started. Unfortunately, she failed to continue the treatment due to a shortage of supply of the medication. A few months later, she got pregnant and developed threatened abortion, which ended with a miscarriage. This case illustrates the need to consider this disease in the differential diagnoses when dealing with unexplained thrombocytopenia, anemia, hepatomegaly, and splenomegaly. There are several challenges in the diagnosis and treatment of Gaucher's disease, particularly in resource-limited settings.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"236 - 239"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46903374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_62_21
E. Habas, Aml Habas, M. Elgamal, Bara A. Shraim, M. Moursi, A. Ibrahim, M. Danjuma, Abdel-Naser Elzouki
Long-term hemodialysis (HD) is the main modality used in the treatment of end-stage renal disease (ESRD). It is associated with a variety of complications such as infection, amyloidosis, anemia, undernutrition, as well as musculoskeletal, and cardiovascular system (CVS) morbidities. CVS complications and HD-related infection are the main causes of death in ESRD patients on HD. Other complications such as stroke, disequilibrium syndrome occur during or post-HD. Missing dialysis sessions may lead to amongst others; death due to sudden cardiac arrhythmias; cardiac arrest due to electrolyte disturbance and/or severe overload. This review discusses the common complications of HD as well as recent advances that are likely to impact its outcome.
{"title":"Common complications of hemodialysis: A clinical review","authors":"E. Habas, Aml Habas, M. Elgamal, Bara A. Shraim, M. Moursi, A. Ibrahim, M. Danjuma, Abdel-Naser Elzouki","doi":"10.4103/ijmbs.ijmbs_62_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_62_21","url":null,"abstract":"Long-term hemodialysis (HD) is the main modality used in the treatment of end-stage renal disease (ESRD). It is associated with a variety of complications such as infection, amyloidosis, anemia, undernutrition, as well as musculoskeletal, and cardiovascular system (CVS) morbidities. CVS complications and HD-related infection are the main causes of death in ESRD patients on HD. Other complications such as stroke, disequilibrium syndrome occur during or post-HD. Missing dialysis sessions may lead to amongst others; death due to sudden cardiac arrhythmias; cardiac arrest due to electrolyte disturbance and/or severe overload. This review discusses the common complications of HD as well as recent advances that are likely to impact its outcome.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"161 - 172"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48449662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijmbs.ijmbs_64_21
Callixte Yadufashije, Jasmine Umugwaneza, Liliane Muhimpundu, Cedrick Izere, Emmanuel Munyeshyaka, A. Mala, N. Francois, J. Mucumbitsi, G. Sangano, Martin Ndayambaje, Lydia Mwanzia, Thierry Habyarimana
Background: Preterm birth is a global public health threat for maternal and child health. Each year, 15 million neonates are born preterm worldwide, with 40% resulting from intrauterine infections. Materials and Methods: This cross-sectional and case–control study was conducted from October to February 2019 at Ruhengeri Referral Hospital. A total of 120 swab samples were collected from 40 women, of which 20 were full-term delivery, while the other 20 were preterm delivery. The three samples, including the placental membranes, amniotic fluids, and fetal membranes, were collected immediately after birth. A sterile cotton swab was used to collect the samples and put into swab Stuart sterile plastic container to avoid sample contamination. Samples were transported in a tightly covered carrier to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant differences between the means of the two groups, while the Chi-square test (χ2) was used to test for significant association with microorganisms and intra-amniotic infections. Results: A half of the participants were in the age range of 24–29 years. Non-albicans candida (32.7%) and mold (27.9%) were the predominant microorganisms isolated. Non-albicans candida and mold were common to preterm and full-term samples. Staphylococcus species were observed in placental and fetal membrane samples. Escherichia coli, Klebsiella species, Streptococcus species, and Candida albicans were observed among women with preterm birth samples. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P < 0.007), placental membrane isolates (t = 7.17, P < 0.0004), and fetal membrane isolates (t = 6.7, P < 0.0006). Association with microorganisms and intra-amniotic infection was statistically significant with E. coli (χ2 = 3.98, P < 0.05), Streptococcus species (χ2 = 5.53, P < 0.019), non-albicans candida (χ2 = 8.37, P < 0.004), and C. albicans (χ2 = 3.98, P < 0.05). Conclusions: Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.
{"title":"Identification of Microorganisms associated with intraamniotic infection among women with preterm birth at Ruhengeri Referral Hospital, Rwanda: A case control study","authors":"Callixte Yadufashije, Jasmine Umugwaneza, Liliane Muhimpundu, Cedrick Izere, Emmanuel Munyeshyaka, A. Mala, N. Francois, J. Mucumbitsi, G. Sangano, Martin Ndayambaje, Lydia Mwanzia, Thierry Habyarimana","doi":"10.4103/ijmbs.ijmbs_64_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_64_21","url":null,"abstract":"Background: Preterm birth is a global public health threat for maternal and child health. Each year, 15 million neonates are born preterm worldwide, with 40% resulting from intrauterine infections. Materials and Methods: This cross-sectional and case–control study was conducted from October to February 2019 at Ruhengeri Referral Hospital. A total of 120 swab samples were collected from 40 women, of which 20 were full-term delivery, while the other 20 were preterm delivery. The three samples, including the placental membranes, amniotic fluids, and fetal membranes, were collected immediately after birth. A sterile cotton swab was used to collect the samples and put into swab Stuart sterile plastic container to avoid sample contamination. Samples were transported in a tightly covered carrier to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant differences between the means of the two groups, while the Chi-square test (χ2) was used to test for significant association with microorganisms and intra-amniotic infections. Results: A half of the participants were in the age range of 24–29 years. Non-albicans candida (32.7%) and mold (27.9%) were the predominant microorganisms isolated. Non-albicans candida and mold were common to preterm and full-term samples. Staphylococcus species were observed in placental and fetal membrane samples. Escherichia coli, Klebsiella species, Streptococcus species, and Candida albicans were observed among women with preterm birth samples. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P < 0.007), placental membrane isolates (t = 7.17, P < 0.0004), and fetal membrane isolates (t = 6.7, P < 0.0006). Association with microorganisms and intra-amniotic infection was statistically significant with E. coli (χ2 = 3.98, P < 0.05), Streptococcus species (χ2 = 5.53, P < 0.019), non-albicans candida (χ2 = 8.37, P < 0.004), and C. albicans (χ2 = 3.98, P < 0.05). Conclusions: Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"196 - 203"},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44118586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijmbs.ijmbs_43_21
F. Selvi, C. Bedel, M. Korkut
Background: The pathophysiology of COVID-19 disease is not clearly understood; inflammation has been shown to play a major role. The immature granulocytes count (IGC) can be an indicator of inflammation. To the best of our knowledge, there is no data on the usability of IGC for the diagnosis of COVID-19. Objectives: We aim to investigate the usability of the inflammatory marker IGC in the diagnosis of COVID-19. Patients and Methods: COVID-19 patients admitted to a tertiary university hospital were included in this study, and hemogram parameters, white blood cells, hemoglobin, neutrophils, lymphocytes, and IGC were investigated. According to the real-time reverse transcriptional polymerase chain reaction, patients were categorized into two groups as COVID-19 positive and COVID-19 negative. Results: The mean value of IGC was 0.02 (0.02) for the COVID-19-positive group and 0.11 (0.04) for the COVID-19-negative group. Patients with COVID-19 positive were found to have an IGC value that is significantly lower than the other group (P < 0.001). For IGC, it was calculated at a cut-off value of 0.03 (area under the curve: 0.718; sensitivity: 66.7%; specificity: 72.3%; P < 0.001). Conclusions: The results of our study have shown that on-admission IGC level is a novel, cost-effective, and readily available biomarker with a promising predictive marker for COVID-19 patients.
{"title":"Can the immature granulocyte count have a role in the diagnosis of coronavirus 2019 disease?","authors":"F. Selvi, C. Bedel, M. Korkut","doi":"10.4103/ijmbs.ijmbs_43_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_43_21","url":null,"abstract":"Background: The pathophysiology of COVID-19 disease is not clearly understood; inflammation has been shown to play a major role. The immature granulocytes count (IGC) can be an indicator of inflammation. To the best of our knowledge, there is no data on the usability of IGC for the diagnosis of COVID-19. Objectives: We aim to investigate the usability of the inflammatory marker IGC in the diagnosis of COVID-19. Patients and Methods: COVID-19 patients admitted to a tertiary university hospital were included in this study, and hemogram parameters, white blood cells, hemoglobin, neutrophils, lymphocytes, and IGC were investigated. According to the real-time reverse transcriptional polymerase chain reaction, patients were categorized into two groups as COVID-19 positive and COVID-19 negative. Results: The mean value of IGC was 0.02 (0.02) for the COVID-19-positive group and 0.11 (0.04) for the COVID-19-negative group. Patients with COVID-19 positive were found to have an IGC value that is significantly lower than the other group (P < 0.001). For IGC, it was calculated at a cut-off value of 0.03 (area under the curve: 0.718; sensitivity: 66.7%; specificity: 72.3%; P < 0.001). Conclusions: The results of our study have shown that on-admission IGC level is a novel, cost-effective, and readily available biomarker with a promising predictive marker for COVID-19 patients.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"136 - 141"},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49317461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijmbs.ijmbs_63_21
E. Elkhammas, S. Beshyah
{"title":"Life and medicine: COVID-19 and beyond","authors":"E. Elkhammas, S. Beshyah","doi":"10.4103/ijmbs.ijmbs_63_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_63_21","url":null,"abstract":"","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"101 - 101"},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41368488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijmbs.ijmbs_144_20
S. Bukhatwa, El-Said Metmoah
Introduction: Trabeculectomy controls the intraocular pressure (IOP) and decreases the progress of open-angle glaucoma; the outcome of such procedure has not been ascertained in Libya. Objective: We report the short-term outcome of trabeculectomy in terms of IOP in primary open-angle glaucoma (POAG). Settings and Design: The medical records of the trabeculectomy patients previously diagnosed with POAG were reviewed retrospectively. Patients and Methods: Case characteristics were extracted including preoperative IOP and the IOP outcome 6 months postoperatively using Goldmann applanation tonometry. Data were presented as frequencies and mean ± standard deviation. Wilcoxon signed-ranks test was used to analyze the changes in the measurement of IOP after trabeculectomy. Results: Fifty-seven cases had trabeculectomy with a mean age of 51.6 ± 12.2 years. There was a statistically difference (P < 0.0001) in the IOP measurement pre and 6 months post trabeculectomy. 39 patients (68.4%) achieved an IOP of ≤21 mmHg 6 months after surgery without medications. IOP decreased from 33.2 ± 6.5 mmHg before surgery to 18.8 ± 5.8 mmHg after surgery. All the cases with preoperative IOP of 21–30 mmHg had a posttrabeculectomy IOP ≤ 21 mmHg (P < 0.0001). The rate of complications was low; seven eyes (12.3%) developed early postoperative complications that resolved within 2 weeks. Conclusions: This is the first report on trabeculectomy surgery in Libya. The results are encouraging with a low complication rate. This warrants further evaluationsof long term outcomes.
{"title":"Short-term outcomes of trabeculectomy surgery in primary open-angle glaucoma","authors":"S. Bukhatwa, El-Said Metmoah","doi":"10.4103/ijmbs.ijmbs_144_20","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_144_20","url":null,"abstract":"Introduction: Trabeculectomy controls the intraocular pressure (IOP) and decreases the progress of open-angle glaucoma; the outcome of such procedure has not been ascertained in Libya. Objective: We report the short-term outcome of trabeculectomy in terms of IOP in primary open-angle glaucoma (POAG). Settings and Design: The medical records of the trabeculectomy patients previously diagnosed with POAG were reviewed retrospectively. Patients and Methods: Case characteristics were extracted including preoperative IOP and the IOP outcome 6 months postoperatively using Goldmann applanation tonometry. Data were presented as frequencies and mean ± standard deviation. Wilcoxon signed-ranks test was used to analyze the changes in the measurement of IOP after trabeculectomy. Results: Fifty-seven cases had trabeculectomy with a mean age of 51.6 ± 12.2 years. There was a statistically difference (P < 0.0001) in the IOP measurement pre and 6 months post trabeculectomy. 39 patients (68.4%) achieved an IOP of ≤21 mmHg 6 months after surgery without medications. IOP decreased from 33.2 ± 6.5 mmHg before surgery to 18.8 ± 5.8 mmHg after surgery. All the cases with preoperative IOP of 21–30 mmHg had a posttrabeculectomy IOP ≤ 21 mmHg (P < 0.0001). The rate of complications was low; seven eyes (12.3%) developed early postoperative complications that resolved within 2 weeks. Conclusions: This is the first report on trabeculectomy surgery in Libya. The results are encouraging with a low complication rate. This warrants further evaluationsof long term outcomes.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"122 - 126"},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43175905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijmbs.ijmbs_48_21
S. Alqutub, W. Albalawi, N. Alrajhi
Background: In March 2020, Saudi Arabia (KSA) experienced a coronavirus disease 2019 (COVID-19) outbreak. The mitigation strategy aimed to reduce both the impact on vulnerable groups and the risk of admission to the intensive care unit (ICU). Risk factors, such as sequential organ failure, comorbidities, ventilation, and mortality, have not been described in different settings of care. Materials and Methods: A multicenter, retrospective chart review of 220 adults with COVID-19 admitted to the ICU included demographics and ICU admission factors (e.g., quick sequential organ failure assessment (qSOFA) score, ventilator status, comorbidities, days from laboratory confirmation to ICU admission, and days from hospitalization to ICU admission). Regression was utilized to identify predictors of need for mechanical ventilation (MV) and mortality in ICU patients. Results: ICU admission, COVID-19 hospital mortality, and ventilator-associated mortality rates were 26.5%, 44%, and 30.5%, respectively. The mean patients' age was 30 years. Across four cities, Jeddah patients were at the highest risk of MV (<0.001). Within the 1st day of hospitalization, without lymphocytopenia, non-Saudi patients with a qSOFA score of 2 and 3 were at the highest risk of ventilation (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.72–8.66; OR, 11.4; 95% CI, 2.35–55.47; and OR, 6.1; 95% CI, 1.0–37.33, respectively). Moreover, within the same period of hospital stay, mechanically-ventilated patients with a qSOFA score of 3 who received antiviral medications were significantly at the higher risk of death (OR, 2.8.4; 95% CI, 1.44–5.64; OR, 13.1; 95% CI, 1.23–39.68; and OR, 2.2; 95% CI, 1.14–4.14, respectively). Conclusions: The 1st day of hospitalization, along with an assessment of the dyspnea status using the qSOFA score, is the window of opportunity for minimizing ICU admission risk. Neither lymphocytopenia nor comorbidities are associated with the risk of mechanical ventilation. Factors were also discussed. Reviews are needed on the indications for the use of antiviral agents, intubation, and ventilation in hospitalized patients.
{"title":"Determinants of intensive care unit admission of hospitalized patients with COVID-19 in Saudi Arabia: An analytic retrospective cohort","authors":"S. Alqutub, W. Albalawi, N. Alrajhi","doi":"10.4103/ijmbs.ijmbs_48_21","DOIUrl":"https://doi.org/10.4103/ijmbs.ijmbs_48_21","url":null,"abstract":"Background: In March 2020, Saudi Arabia (KSA) experienced a coronavirus disease 2019 (COVID-19) outbreak. The mitigation strategy aimed to reduce both the impact on vulnerable groups and the risk of admission to the intensive care unit (ICU). Risk factors, such as sequential organ failure, comorbidities, ventilation, and mortality, have not been described in different settings of care. Materials and Methods: A multicenter, retrospective chart review of 220 adults with COVID-19 admitted to the ICU included demographics and ICU admission factors (e.g., quick sequential organ failure assessment (qSOFA) score, ventilator status, comorbidities, days from laboratory confirmation to ICU admission, and days from hospitalization to ICU admission). Regression was utilized to identify predictors of need for mechanical ventilation (MV) and mortality in ICU patients. Results: ICU admission, COVID-19 hospital mortality, and ventilator-associated mortality rates were 26.5%, 44%, and 30.5%, respectively. The mean patients' age was 30 years. Across four cities, Jeddah patients were at the highest risk of MV (<0.001). Within the 1st day of hospitalization, without lymphocytopenia, non-Saudi patients with a qSOFA score of 2 and 3 were at the highest risk of ventilation (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.72–8.66; OR, 11.4; 95% CI, 2.35–55.47; and OR, 6.1; 95% CI, 1.0–37.33, respectively). Moreover, within the same period of hospital stay, mechanically-ventilated patients with a qSOFA score of 3 who received antiviral medications were significantly at the higher risk of death (OR, 2.8.4; 95% CI, 1.44–5.64; OR, 13.1; 95% CI, 1.23–39.68; and OR, 2.2; 95% CI, 1.14–4.14, respectively). Conclusions: The 1st day of hospitalization, along with an assessment of the dyspnea status using the qSOFA score, is the window of opportunity for minimizing ICU admission risk. Neither lymphocytopenia nor comorbidities are associated with the risk of mechanical ventilation. Factors were also discussed. Reviews are needed on the indications for the use of antiviral agents, intubation, and ventilation in hospitalized patients.","PeriodicalId":13067,"journal":{"name":"Ibnosina Journal of Medicine and Biomedical Sciences","volume":"13 1","pages":"127 - 135"},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41397429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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