Insulin analogs are preferred by many physicians over human insulins in the management of Type 1 diabetes and in patients with Type 2 diabetes who require insulin. Insulin analogs have a pharmacological profile that is close to the normal physiological action of insulin. There is a notion among some clinicians that insulin analogs offer advantages over human insulins, including better glucose control, less hypoglycemia, and flexibility. A large number of clinical studies, along with systematic reviews, have compared insulin analogs to human insulins in regard to glucose control, rates of hypoglycemia, quality of life, and cost-effectiveness. For Type 1 diabetes, rapid-acting insulin analogs offer better glucose control and less rates of hypoglycemia compared to regular human insulin. Long-acting basal insulins result in less nocturnal hypoglycemia compared to neutral protamine Hagedorn (NPH) insulin but no difference in glucose control in patients with Type 1 diabetes. For patients with Type 2 diabetes, rapid-acting insulins offer no advantage for glucose control or rates of hypoglycemia when compared to regular insulin. There was only a reduction in rates of nocturnal hypoglycemia with no difference in glucose control with the use of basal insulin analogs compared to NPH insulin in Type 2 diabetes. The cost of insulin analogs is considerably higher than human insulins and favorable cost-effectiveness was only demonstrated with rapid-acting insulin analogs in Type 1 diabetes. The available evidence does not support the routine use of insulin analogs over human insulins. There are only few situations where insulin analogs have shown clear benefit over human insulin. In a large percentage of patients cost consideration and lack of better glucose control would favor the use of human insulins.
{"title":"Insulin analogs versus human insulins for the management of diabetes: An evidence-based review","authors":"M. Eledrisi","doi":"10.4103/ljms.ljms_96_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_96_20","url":null,"abstract":"Insulin analogs are preferred by many physicians over human insulins in the management of Type 1 diabetes and in patients with Type 2 diabetes who require insulin. Insulin analogs have a pharmacological profile that is close to the normal physiological action of insulin. There is a notion among some clinicians that insulin analogs offer advantages over human insulins, including better glucose control, less hypoglycemia, and flexibility. A large number of clinical studies, along with systematic reviews, have compared insulin analogs to human insulins in regard to glucose control, rates of hypoglycemia, quality of life, and cost-effectiveness. For Type 1 diabetes, rapid-acting insulin analogs offer better glucose control and less rates of hypoglycemia compared to regular human insulin. Long-acting basal insulins result in less nocturnal hypoglycemia compared to neutral protamine Hagedorn (NPH) insulin but no difference in glucose control in patients with Type 1 diabetes. For patients with Type 2 diabetes, rapid-acting insulins offer no advantage for glucose control or rates of hypoglycemia when compared to regular insulin. There was only a reduction in rates of nocturnal hypoglycemia with no difference in glucose control with the use of basal insulin analogs compared to NPH insulin in Type 2 diabetes. The cost of insulin analogs is considerably higher than human insulins and favorable cost-effectiveness was only demonstrated with rapid-acting insulin analogs in Type 1 diabetes. The available evidence does not support the routine use of insulin analogs over human insulins. There are only few situations where insulin analogs have shown clear benefit over human insulin. In a large percentage of patients cost consideration and lack of better glucose control would favor the use of human insulins.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"495 1","pages":"164 - 168"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80013461","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}
Mohammad N. Kloub, Mousa Alhiyari, Jabeed Parengal, Elmahdi Errayes, M. Yassin
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection is now a pandemic distributed worldwide. All age groups are susceptible to infection, the elderly population, and those with a background of chronic medical comorbidities being particularly vulnerable for severe symptoms and complicated outcome. SARS-CoV-2 infection mainly targets the respiratory system and can establish infection in the upper part of the respiratory tract as well as the lower part of the respiratory tract, presenting in a spectrum ranging from asymptomatic infection reaching up to severe acute respiratory distress syndrome; however, the viral infection is not solely confined to the respiratory system as many cases have been reported where the patients present with different bodily system symptoms without having respiratory symptoms as usual. We report a 51-year old male who presented with symptoms of fever and dry cough and was diagnosed as a case of COVID-19 pneumonia that was later complicated by meningoencephalitis. The patient underwent diagnostic neuroimaging and lumbar puncture; patient received therapy with intravenous acyclovir and intravenous ceftraixone and improved with a favorable outcome. Meningioencephalitis is a serious neurological complication of SARS-CoV-2 infection and should be suspected in patients who develop signs and symptoms suggesting this condition, and we aim from publishing this case to draw attention to this serious complication.
{"title":"SARS-CoV-2 infection associated-meningoencephalitis treated with acyclovir","authors":"Mohammad N. Kloub, Mousa Alhiyari, Jabeed Parengal, Elmahdi Errayes, M. Yassin","doi":"10.4103/ljms.ljms_97_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_97_20","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection is now a pandemic distributed worldwide. All age groups are susceptible to infection, the elderly population, and those with a background of chronic medical comorbidities being particularly vulnerable for severe symptoms and complicated outcome. SARS-CoV-2 infection mainly targets the respiratory system and can establish infection in the upper part of the respiratory tract as well as the lower part of the respiratory tract, presenting in a spectrum ranging from asymptomatic infection reaching up to severe acute respiratory distress syndrome; however, the viral infection is not solely confined to the respiratory system as many cases have been reported where the patients present with different bodily system symptoms without having respiratory symptoms as usual. We report a 51-year old male who presented with symptoms of fever and dry cough and was diagnosed as a case of COVID-19 pneumonia that was later complicated by meningoencephalitis. The patient underwent diagnostic neuroimaging and lumbar puncture; patient received therapy with intravenous acyclovir and intravenous ceftraixone and improved with a favorable outcome. Meningioencephalitis is a serious neurological complication of SARS-CoV-2 infection and should be suspected in patients who develop signs and symptoms suggesting this condition, and we aim from publishing this case to draw attention to this serious complication.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"15 1","pages":"198 - 200"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91538337","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}
Rema Shampe, Raga A. Elzahaf, M. Al-Jaghbir, A. Battah
Background: Dental clinics are important and essential for the health and safety of individuals in the community and they are indispensable for the provision of medical and therapeutic services for the diagnosis of oral diseases, gum and teeth. As important as the other health centers, good and appropriate management of medical waste in dental clinics is very important to ensure safety for staff in the clinic. Objectives: Evaluating the level of medical waste management in dental clinics in Tripoli/ Libya. Methods: A cross-sectional study was conducted on 201 respondents: dentists, nurses, and assistants dentist chosen from 67 clinics out of 135 clinics. A questionnaire was used to two sections. The data were analyzed by using the IBM Statistical Package for Social Sciences (IBM SPSS) software, version 19.0 (SPSS Inc.). Results: 39.8% of respondents who were separating contaminated blood from non-contaminated waste and 82.1% of respondent's disposal liquid waste such as blood and saliva through the sewage network. However, there was no statistically significant difference in medical waste management between male and female dental staff in Tripoli, Libya (t = 0.376, P = 0.170). Conclusions: The methods of medical waste management practiced in the most dental clinics were inappropriate. The study demonstrated that there was lack of knowledge among workers in dental clinics regarding the disposal procedures and dealing with waste. Therefore, it is necessary to re-assess safety protocols by authorities and intervene quickly by introducing spread awareness of health and safety in dental clinics and in forcing regulations.
背景:牙科诊所对社会上个人的健康和安全至关重要，而且在提供诊断口腔疾病、牙龈和牙齿的医疗和治疗服务方面也是不可或缺的。与其他保健中心一样重要的是，对牙科诊所的医疗废物进行良好和适当的管理对于确保诊所工作人员的安全非常重要。目标:评估利比亚的黎波里牙科诊所医疗废物管理水平。方法:采用横断面研究对来自135个诊所中的67个诊所的201名受访牙医、护士和助理牙医进行调查。问卷分为两部分。采用IBM SPSS 19.0版社会科学统计软件包(IBM SPSS)软件(SPSS Inc.)进行数据分析。结果:39.8%的受访者将受污染的血液与未受污染的废物进行分离，82.1%的受访者通过污水管网处理血液、唾液等液体废物。然而，在利比亚的黎波里，男性和女性牙科工作人员在医疗废物管理方面没有统计学上的显著差异(t = 0.376, P = 0.170)。结论:大多数牙科诊所的医疗废物管理方法不合理。研究表明，牙科诊所的工作人员缺乏关于废物处置程序和处理的知识。因此，有必要重新评估当局的安全协议，并通过在牙科诊所普及健康和安全意识和强制法规迅速进行干预。
{"title":"Medical waste management in dental clinics in Tripoli/Libya","authors":"Rema Shampe, Raga A. Elzahaf, M. Al-Jaghbir, A. Battah","doi":"10.4103/ljms.ljms_25_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_25_20","url":null,"abstract":"Background: Dental clinics are important and essential for the health and safety of individuals in the community and they are indispensable for the provision of medical and therapeutic services for the diagnosis of oral diseases, gum and teeth. As important as the other health centers, good and appropriate management of medical waste in dental clinics is very important to ensure safety for staff in the clinic. Objectives: Evaluating the level of medical waste management in dental clinics in Tripoli/ Libya. Methods: A cross-sectional study was conducted on 201 respondents: dentists, nurses, and assistants dentist chosen from 67 clinics out of 135 clinics. A questionnaire was used to two sections. The data were analyzed by using the IBM Statistical Package for Social Sciences (IBM SPSS) software, version 19.0 (SPSS Inc.). Results: 39.8% of respondents who were separating contaminated blood from non-contaminated waste and 82.1% of respondent's disposal liquid waste such as blood and saliva through the sewage network. However, there was no statistically significant difference in medical waste management between male and female dental staff in Tripoli, Libya (t = 0.376, P = 0.170). Conclusions: The methods of medical waste management practiced in the most dental clinics were inappropriate. The study demonstrated that there was lack of knowledge among workers in dental clinics regarding the disposal procedures and dealing with waste. Therefore, it is necessary to re-assess safety protocols by authorities and intervene quickly by introducing spread awareness of health and safety in dental clinics and in forcing regulations.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"64 1","pages":"174 - 178"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90148293","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}
Hypocalcemia is a common electrolyte disturbance with a variety of causes. Hypoparathyroidism, sensorineural deafness, and renal disease (HDR) syndrome is a rare autosomal-dominant genetic disorder characterized by hypoparathyroidism, sensorineural deafness, and renal disease. This is a case presentation of HDR syndrome that had been referred to a hospital with hypocalcemia. This case has a unique feature as it has been diagnosed in adult age because usually HDR syndrome is diagnosed in pediatric age group.
{"title":"A rare cause of hypocalcemia: Hypoparathyroidism, sensorineural deafness, and renal disease syndrome","authors":"S. Benamer, P. Jennings","doi":"10.4103/ljms.ljms_81_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_81_20","url":null,"abstract":"Hypocalcemia is a common electrolyte disturbance with a variety of causes. Hypoparathyroidism, sensorineural deafness, and renal disease (HDR) syndrome is a rare autosomal-dominant genetic disorder characterized by hypoparathyroidism, sensorineural deafness, and renal disease. This is a case presentation of HDR syndrome that had been referred to a hospital with hypocalcemia. This case has a unique feature as it has been diagnosed in adult age because usually HDR syndrome is diagnosed in pediatric age group.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"34 1","pages":"196 - 197"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88164995","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}
Background/Aim: External carotid artery (ECA) shows a variable branching pattern of its stemming vessels. The aim of this study was to investigate the variations in the origin of the three primary anterior branches of the ECA: superior thyroid artery (STA), lingual artery (LA), and facial artery (FA). Methods: The branching pattern of the ECA was studied on 15 Thiel embalmed cadavers of Scottish population (7 males and 8 females). The carotid triangle was dissected bilaterally to uncover the common carotid artery (CCA), internal carotid artery and ECA. The level of carotid artery bifurcation (CB) was located. Variation of the branching patterns of the ECA was assessed. Moreover, the distances between the origin sites of these vessels and the site of the CB were measured. Results: The STA was found to arise more frequently from the ECA (60%) than from the CCA (40%), with no differences in distribution between sexes or sides. Regarding the assessment of the branching patterns of the ECA, the specimens where the STA, LA, and FA emerged as individual branches were 90% of cases, linguofacial trunk cases were 6.7%, and thyrolinguofacial trunk cases were 3.3%. The distances from the vessel origin site to the CB were found to be 8.11 ± 2.77 mm, 19.38 ± 8.85 mm, and 27.95 ± 10.15 mm, for the STA, LA, and FA, respectively. Conclusions: The current findings have confirmed that the ECA branching pattern is highly variable in Thiel embalmed cadavers of Scottish population. Therefore, considering some radiological imaging before conducting any invasive procedure in the neck region could be vital to prevent iatrogenic injuries.
{"title":"Variation in the branching pattern of the anterior branches of the external carotid artery","authors":"M. Elsllabi, S. Garoushi, K. Aneiba, O. Tashani","doi":"10.4103/ljms.ljms_53_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_53_20","url":null,"abstract":"Background/Aim: External carotid artery (ECA) shows a variable branching pattern of its stemming vessels. The aim of this study was to investigate the variations in the origin of the three primary anterior branches of the ECA: superior thyroid artery (STA), lingual artery (LA), and facial artery (FA). Methods: The branching pattern of the ECA was studied on 15 Thiel embalmed cadavers of Scottish population (7 males and 8 females). The carotid triangle was dissected bilaterally to uncover the common carotid artery (CCA), internal carotid artery and ECA. The level of carotid artery bifurcation (CB) was located. Variation of the branching patterns of the ECA was assessed. Moreover, the distances between the origin sites of these vessels and the site of the CB were measured. Results: The STA was found to arise more frequently from the ECA (60%) than from the CCA (40%), with no differences in distribution between sexes or sides. Regarding the assessment of the branching patterns of the ECA, the specimens where the STA, LA, and FA emerged as individual branches were 90% of cases, linguofacial trunk cases were 6.7%, and thyrolinguofacial trunk cases were 3.3%. The distances from the vessel origin site to the CB were found to be 8.11 ± 2.77 mm, 19.38 ± 8.85 mm, and 27.95 ± 10.15 mm, for the STA, LA, and FA, respectively. Conclusions: The current findings have confirmed that the ECA branching pattern is highly variable in Thiel embalmed cadavers of Scottish population. Therefore, considering some radiological imaging before conducting any invasive procedure in the neck region could be vital to prevent iatrogenic injuries.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"452 1","pages":"184 - 187"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82928000","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}
Background: patient safety is a critical component of health-care quality, and it is considered as an important issue worldwide. This study aimed to assess patient safety culture (PSC) among nurses and to investigate the areas of deficiencies for improvement. Methods: A descriptive cross-sectional study was conducted on nurses working at Benghazi Children's Hospital. A self-administered questionnaire containing 12 dimensions was used to assess the Hospital Survey on PSC including patient safety grade and number of events reported. Results: Only 87 of the total 118 distributed questionnaires were returned, giving a response rate of 73.7%. The overall positive response rate of PSC was 47%. The dimension with the highest positive score and considered areas of strength were teamwork within units (72%). The dimension with the lowest percentage of positive response rate was nonpunitive response to error (30%). Conclusion: Improving PSC should be a priority among hospital administrators. Staff should be encouraged to report errors spontaneously and without any fear.
{"title":"Assessment of patient safety culture in benghazi children's hospital from the viewpoint of nursing staff","authors":"Ainas Eltarhuni, Hajir Tawfeeq, Jebril El-Abidi","doi":"10.4103/ljms.ljms_79_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_79_20","url":null,"abstract":"Background: patient safety is a critical component of health-care quality, and it is considered as an important issue worldwide. This study aimed to assess patient safety culture (PSC) among nurses and to investigate the areas of deficiencies for improvement. Methods: A descriptive cross-sectional study was conducted on nurses working at Benghazi Children's Hospital. A self-administered questionnaire containing 12 dimensions was used to assess the Hospital Survey on PSC including patient safety grade and number of events reported. Results: Only 87 of the total 118 distributed questionnaires were returned, giving a response rate of 73.7%. The overall positive response rate of PSC was 47%. The dimension with the highest positive score and considered areas of strength were teamwork within units (72%). The dimension with the lowest percentage of positive response rate was nonpunitive response to error (30%). Conclusion: Improving PSC should be a priority among hospital administrators. Staff should be encouraged to report errors spontaneously and without any fear.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"26 1","pages":"179 - 183"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90946680","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 : 2020-10-01DOI: 10.4103/ljms.ljms_102_20
M. Danjuma
{"title":"Environmental practices and serum Vitamin D deficiency","authors":"M. Danjuma","doi":"10.4103/ljms.ljms_102_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_102_20","url":null,"abstract":"","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"8 1","pages":"157 - 158"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74192414","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}
Pharmaceutical services play a crucial role in any health system. Pharmacists are the main health professionals to ensure that people have access to good and safe medicines and to make certain that these medicines are used rationally. While the role of pharmacists in providing health-care services in Libya remains restricted, the scope of pharmacy practice is vast and encompasses a variety of roles and functions. Most of today's pharmacists' services are oriented toward clinical outcomes using medicines. Therefore, pharmacists are focusing on optimizing the use of medications, promoting health, wellness, and preventing diseases. Pharmaceutical services are currently being tailored to be event driven to fit the current COVID-19 pandemic crisis and to help combat this disease and its consequences. This article discusses different pharmaceutical services that can be provided by pharmacists in all practice settings, for the Libyan healthcare system and to the society in general during COVID-19 crisis.
{"title":"Provision of pharmaceutical services in time of COVID-19 crisis: A libyan vision","authors":"Amal Y. Benkorah","doi":"10.4103/ljms.ljms_48_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_48_20","url":null,"abstract":"Pharmaceutical services play a crucial role in any health system. Pharmacists are the main health professionals to ensure that people have access to good and safe medicines and to make certain that these medicines are used rationally. While the role of pharmacists in providing health-care services in Libya remains restricted, the scope of pharmacy practice is vast and encompasses a variety of roles and functions. Most of today's pharmacists' services are oriented toward clinical outcomes using medicines. Therefore, pharmacists are focusing on optimizing the use of medications, promoting health, wellness, and preventing diseases. Pharmaceutical services are currently being tailored to be event driven to fit the current COVID-19 pandemic crisis and to help combat this disease and its consequences. This article discusses different pharmaceutical services that can be provided by pharmacists in all practice settings, for the Libyan healthcare system and to the society in general during COVID-19 crisis.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"46 1","pages":"159 - 163"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86753325","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}
Mohamed O. Ezwaie, Hani Elgahwagi, Najat M Aloshibi, Fatma Rugrug
Kidney transplant kidney transplant (KTx) recipients have increased susceptibility to a spectrum of infections including; bacterial, viral, and fungal pathogens. Many factors contribute to their infection potential risk, in terms of their immunosuppressive state, that result in suppression of their B-and T-lymphocyte repertoire, also to consider certain donor and recipient-related factors, that make them at risk of specific type of infectious complications. In addition kidney transplant patients tolerate poorly infections, which may adversely affect their graft function, by inducing glomerular injury, hence early diagnosis, directed therapy, and careful dosing of antimicrobial agents is of paramount importance in reducing patient's morbidity and mortality. We report a kidney transplant patient, who received her live related kidney graft 7 years earlier (in 2013), she has been with stable graft function in most of her follow up period, until she presented with pyrexia, dyspnea and fatigue associated with deterioration of her graft function.
{"title":"A challenging presentation of pyrexia and macroscopic hematuria in a kidney transplant patient","authors":"Mohamed O. Ezwaie, Hani Elgahwagi, Najat M Aloshibi, Fatma Rugrug","doi":"10.4103/LJMS.LJMS_17_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_17_20","url":null,"abstract":"Kidney transplant kidney transplant (KTx) recipients have increased susceptibility to a spectrum of infections including; bacterial, viral, and fungal pathogens. Many factors contribute to their infection potential risk, in terms of their immunosuppressive state, that result in suppression of their B-and T-lymphocyte repertoire, also to consider certain donor and recipient-related factors, that make them at risk of specific type of infectious complications. In addition kidney transplant patients tolerate poorly infections, which may adversely affect their graft function, by inducing glomerular injury, hence early diagnosis, directed therapy, and careful dosing of antimicrobial agents is of paramount importance in reducing patient's morbidity and mortality. We report a kidney transplant patient, who received her live related kidney graft 7 years earlier (in 2013), she has been with stable graft function in most of her follow up period, until she presented with pyrexia, dyspnea and fatigue associated with deterioration of her graft function.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"167 2","pages":"133 - 136"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72705678","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}
Bloodletting as a treatment for various diseases is an ancient belief; nowadays, it is practiced in many communities, especially in Asia and the Middle East. Among others, cupping is one form of bloodletting procedure. We are presenting a patient with overvalued belief (idea), he relied on cupping as a therapy to treat his headache. For many years, cupping was done for him every few months, then he tried doing it himself, more frequently. Thereafter; cupping sessions dominated his life in a way that he used to do it every few days and whenever he felt a headache. Over the years, the patient sustained severe anemia, although it was self-induced; however, it was not factitious as his intention was to cure himself rather than inducing self-harm. Management was a challenge as it was difficult to convince him to stop this practice and to consult psychiatrist.
{"title":"Self-induced anemia secondary to overvalued belief on cupping: A Case report and review of the literature","authors":"Abdulhak A Sadalla, A. Hussein, Mohammed A Amer","doi":"10.4103/LJMS.LJMS_45_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_45_20","url":null,"abstract":"Bloodletting as a treatment for various diseases is an ancient belief; nowadays, it is practiced in many communities, especially in Asia and the Middle East. Among others, cupping is one form of bloodletting procedure. We are presenting a patient with overvalued belief (idea), he relied on cupping as a therapy to treat his headache. For many years, cupping was done for him every few months, then he tried doing it himself, more frequently. Thereafter; cupping sessions dominated his life in a way that he used to do it every few days and whenever he felt a headache. Over the years, the patient sustained severe anemia, although it was self-induced; however, it was not factitious as his intention was to cure himself rather than inducing self-harm. Management was a challenge as it was difficult to convince him to stop this practice and to consult psychiatrist.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"79 1","pages":"137 - 139"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77303939","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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