E. Bousoik, N. Alhusadi, Hana Alzawi, Rehab Ramadhan, Rawaa Albarassi
Abstract Background Prescriptions, medicolegal documents issued by physicians to patients, must be written accurately and clearly, contain all the required information, and adhere to the guidelines for prescription writing. In eastern Libya, most prescriptions are handwritten. Incomplete prescriptions might lead to serious medication errors. Aim The aim of this article was to assess the completeness of handwritten prescriptions issued by physicians working in eastern Libya. Method A total of 1,080 handwritten prescriptions were collected from pharmacies in different parts of the city of Derna and its suburbs in eastern Libya. After the exclusion of three prescriptions that were defined as illegible by the researchers, the 1,077 remaining prescriptions were examined for completeness against a checklist designed according to the guidelines of the World Health Organization (WHO). Results Most of the prescriptions (84.12%) did not contain the name of the prescribing physician. The patient's name was not mentioned on 16.06% of the prescriptions. Patient-related information was missing in most of the prescriptions. Most of the physicians (91.27%) prescribed drugs using their trade names. Drug strength, route of drug administration, and duration of therapy were absent in 29.61, 87, and 56.17% of the prescriptions, respectively. Only 26% of the prescriptions contained the date. Conclusion Most of the prescriptions inspected in this study had some deficiencies and did not adhere to the WHO guidelines.
{"title":"Assessment of Completeness of Handwritten Prescriptions in Eastern Libya","authors":"E. Bousoik, N. Alhusadi, Hana Alzawi, Rehab Ramadhan, Rawaa Albarassi","doi":"10.1055/s-0043-1768932","DOIUrl":"https://doi.org/10.1055/s-0043-1768932","url":null,"abstract":"Abstract Background Prescriptions, medicolegal documents issued by physicians to patients, must be written accurately and clearly, contain all the required information, and adhere to the guidelines for prescription writing. In eastern Libya, most prescriptions are handwritten. Incomplete prescriptions might lead to serious medication errors. Aim The aim of this article was to assess the completeness of handwritten prescriptions issued by physicians working in eastern Libya. Method A total of 1,080 handwritten prescriptions were collected from pharmacies in different parts of the city of Derna and its suburbs in eastern Libya. After the exclusion of three prescriptions that were defined as illegible by the researchers, the 1,077 remaining prescriptions were examined for completeness against a checklist designed according to the guidelines of the World Health Organization (WHO). Results Most of the prescriptions (84.12%) did not contain the name of the prescribing physician. The patient's name was not mentioned on 16.06% of the prescriptions. Patient-related information was missing in most of the prescriptions. Most of the physicians (91.27%) prescribed drugs using their trade names. Drug strength, route of drug administration, and duration of therapy were absent in 29.61, 87, and 56.17% of the prescriptions, respectively. Only 26% of the prescriptions contained the date. Conclusion Most of the prescriptions inspected in this study had some deficiencies and did not adhere to the WHO guidelines.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90867311","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}
Abstract Central nervous system tuberculosis (CNS TB) involves the brain parenchyma, meninges, and spinal cord. The primary pathology in CNS TB includes thick basal exudates leading to intense meningeal inflammation, vasculitis, and hydrocephalus. When these exudates and inflammation predominantly involve the structure in and around suprasellar cistern region, it results in a condition called optochiasmatic arachnoiditis (OCA). OCA is one of the cataclysmal complications of CNS TB, leading to vision loss. A previously healthy young woman came to our center with the complaints of low-grade fever, headache, weight loss, and visual obscuration. For further evaluation, she underwent lumbar puncture, and based on cerebrospinal fluid analysis, she was a diagnosed with CNS TB and was promptly started on antitubercular therapy along with steroid. A contrast-enhanced magnetic resonance imaging of the brain and orbit showed OCA. For OCA, she was given pulse-dose dexamethasone along with intrathecal hyaluronidase with which there was marginal improvement in vision. Management of OCA can be very challenging with unsatisfactory response. Many agents such as pulse steroid, intrathecal hyaluronidase, thalidomide, tumor necrosis factor alpha inhibitors, and cyclophosphamide have been used with inconsistent results. We have also done a review of the literature for the current evidence and newer therapeutics available for the management of OCA.
{"title":"Tubercular Optochiasmatic Arachnoiditis: A Case Report with Current Therapeutics and Management","authors":"S. Swain, A. Didwania, A. Anand, U. Baitha","doi":"10.1055/s-0043-1768222","DOIUrl":"https://doi.org/10.1055/s-0043-1768222","url":null,"abstract":"Abstract Central nervous system tuberculosis (CNS TB) involves the brain parenchyma, meninges, and spinal cord. The primary pathology in CNS TB includes thick basal exudates leading to intense meningeal inflammation, vasculitis, and hydrocephalus. When these exudates and inflammation predominantly involve the structure in and around suprasellar cistern region, it results in a condition called optochiasmatic arachnoiditis (OCA). OCA is one of the cataclysmal complications of CNS TB, leading to vision loss. A previously healthy young woman came to our center with the complaints of low-grade fever, headache, weight loss, and visual obscuration. For further evaluation, she underwent lumbar puncture, and based on cerebrospinal fluid analysis, she was a diagnosed with CNS TB and was promptly started on antitubercular therapy along with steroid. A contrast-enhanced magnetic resonance imaging of the brain and orbit showed OCA. For OCA, she was given pulse-dose dexamethasone along with intrathecal hyaluronidase with which there was marginal improvement in vision. Management of OCA can be very challenging with unsatisfactory response. Many agents such as pulse steroid, intrathecal hyaluronidase, thalidomide, tumor necrosis factor alpha inhibitors, and cyclophosphamide have been used with inconsistent results. We have also done a review of the literature for the current evidence and newer therapeutics available for the management of OCA.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89913412","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}
{"title":"Peer-Review Process: A Dilemma for the Chief Editors","authors":"A. S. Elhwuegi","doi":"10.1055/s-0043-1764153","DOIUrl":"https://doi.org/10.1055/s-0043-1764153","url":null,"abstract":"","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78550923","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}
Abstract Objectives Vanadium (V) metal induces lipid peroxidation (LPO) and this has been proposed as a cause for its neurotoxicity. Aim This study aimed to evaluate the effects of vitamin C (VC) and deferoxamine (DF) against V-induced LPO in brain tissue homogenates in vitro. Methods Male Sprague-Dawley rats were used. Brains were removed and dissected into hypothalamus, hippocampus, brain stem, and medulla pons. They were homogenized in150mM potassium chloride (KCl), and incubated for 1 hour with V, VC, and DF in a micromolar concentration of 20 and 100. Aliquots were used for the estimation of LPO in spectrophotometer. Data analysis were done by one-way analysis of variance. Results V exposure (20 and 100μM) demonstrated statistically significant ( p < 0.001) enhancement of LPO (average increase with 20μMV was by +105% and with 100μMV was by +130%), respectively, in brain tissue homogenates compared with water controls. Hypothalamus exhibited maximum enhancement (average increase with 20μMV was by +145% and with 100μMV was by +175%, respectively), in LPO than other regions. Coexposure of brain tissue homogenates to V + VC (20 and 100μM) further accelerated the LPO (+24% and +16%, respectively) compared with V alone. Brain stem exhibited highest increases (+54% with 20μMV and +21% with 100μMV; p < 0.001), respectively. V-induced oxidative consequences were remarkably inhibited (average -55%; p < 0.001) by DF + V (20μM + 100μM) exposure. Hypothalamus and medulla pons exhibited inhibition, by −66% and −60% ( p < 0.001) respectively. Conclusion V exposure in vitro resulted in oxidative damage with significant regional variations in brain tissue homogenates. VC is pro-oxidative in vitro reactions and DF chelates V-ion moiety.
{"title":"The Peroxidative Changes in Rat Brain Tissue Homogenates by Vitamin C and Deferoxamine against Vanadium-Stimulated Lipid Peroxidation","authors":"Fatum A. El-Shaari, S. Haider, Rehab M-El-Fakhri","doi":"10.1055/s-0043-1767810","DOIUrl":"https://doi.org/10.1055/s-0043-1767810","url":null,"abstract":"Abstract Objectives Vanadium (V) metal induces lipid peroxidation (LPO) and this has been proposed as a cause for its neurotoxicity. Aim This study aimed to evaluate the effects of vitamin C (VC) and deferoxamine (DF) against V-induced LPO in brain tissue homogenates in vitro. Methods Male Sprague-Dawley rats were used. Brains were removed and dissected into hypothalamus, hippocampus, brain stem, and medulla pons. They were homogenized in150mM potassium chloride (KCl), and incubated for 1 hour with V, VC, and DF in a micromolar concentration of 20 and 100. Aliquots were used for the estimation of LPO in spectrophotometer. Data analysis were done by one-way analysis of variance. Results V exposure (20 and 100μM) demonstrated statistically significant ( p < 0.001) enhancement of LPO (average increase with 20μMV was by +105% and with 100μMV was by +130%), respectively, in brain tissue homogenates compared with water controls. Hypothalamus exhibited maximum enhancement (average increase with 20μMV was by +145% and with 100μMV was by +175%, respectively), in LPO than other regions. Coexposure of brain tissue homogenates to V + VC (20 and 100μM) further accelerated the LPO (+24% and +16%, respectively) compared with V alone. Brain stem exhibited highest increases (+54% with 20μMV and +21% with 100μMV; p < 0.001), respectively. V-induced oxidative consequences were remarkably inhibited (average -55%; p < 0.001) by DF + V (20μM + 100μM) exposure. Hypothalamus and medulla pons exhibited inhibition, by −66% and −60% ( p < 0.001) respectively. Conclusion V exposure in vitro resulted in oxidative damage with significant regional variations in brain tissue homogenates. VC is pro-oxidative in vitro reactions and DF chelates V-ion moiety.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87087514","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}
Eman F.A. Altarhouni, Zinelabedin Mohamed, Nama Alhouni
Abstract Background Of the 130 million babies born worldwide each year, an estimated 4 million die during the neonatal period. Of the total global neonatal mortality, 99% occurs in low- and middle-income countries, particularly in Africa and South Asia. The current study was designed to calculate the neonatal mortality rate (NMR), analyze the causes of neonatal deaths, and examine risk factors contributing to neonatal deaths in the neonatal unit of Tobruk Medical Center (TMC). Methods A case-control study was conducted on 180 newborns divided into two groups admitted to the neonatal intensive care unit (NICU) on the same day of delivery. The first group included 90 newborns who died before day 28 and the second group included 90 newborns who survived until the time of discharge and were selected randomly. The data of the patients were collected from the medical records of newborns admitted to the neonatal unit at TMC between July 2018 and July 2019. All data in this study were statistically analyzed using SPSS 23.0 for Windows (SPSS Inc., Chicago, IL, United States). Results The NMR among the studied neonates was 12.3 per 1,000 live births, and the death rate was 16.36% per 1,000 admissions. The most common causes of mortality were premature birth (55, 61%), birth asphyxia (18, 20%), and congenital anomalies (10, 11.2%). Less than 50% of the dead patients were on a mechanical ventilator. Premature birth and low birth weight patients are strong predictors of neonatal mortality; normal vaginal delivery had a higher risk of mortality than the other methods of delivery. Gender, maternal blood group, maternal age, and past obstetrical and medical history had no positive correlation with mortality except for antepartum hemorrhage. Conclusions The study found that the rate of neonatal mortality is similar to that of other hospitals in developing countries and the most common cause of neonatal death was premature birth, and premature birth and low birth weight were the main risk factors for death.
背景在全世界每年出生的1.3亿婴儿中，估计有400万在新生儿期死亡。在全球新生儿死亡总数中，99%发生在低收入和中等收入国家，特别是在非洲和南亚。本研究旨在计算托布鲁克医疗中心(TMC)新生儿病房的新生儿死亡率(NMR)，分析新生儿死亡原因，并检查导致新生儿死亡的危险因素。方法对新生儿重症监护病房(NICU)当日收治的180例新生儿进行病例对照研究，随机分为两组。第一组为28天前死亡的90例新生儿，第二组为存活至出院的90例新生儿，随机选取。患者数据收集自2018年7月至2019年7月在TMC新生儿病房住院的新生儿病历。本研究所有数据采用SPSS 23.0 for Windows (SPSS Inc.， Chicago, IL, United States)进行统计分析。结果新生儿核磁共振率为12.3 / 1000活产，死亡率为16.36% / 1000入院。最常见的死亡原因是早产(55.61%)、出生窒息(18.20%)和先天性异常(10.11.2%)。不到50%的死亡患者使用机械呼吸机。早产和低出生体重患者是新生儿死亡率的强预测因子;正常阴道分娩的死亡率高于其他分娩方式。除产前出血外，性别、母亲血型、母亲年龄、既往产科病史与死亡率无正相关。结论本研究发现，该医院新生儿死亡率与发展中国家其他医院相似，新生儿死亡的最常见原因是早产，早产和低出生体重是死亡的主要危险因素。
{"title":"Common Causes and Risk Factors for Neonatal Death in NICU in Tobruk Medical Center between July 2018 and July 2019, Libya","authors":"Eman F.A. Altarhouni, Zinelabedin Mohamed, Nama Alhouni","doi":"10.1055/s-0043-1770994","DOIUrl":"https://doi.org/10.1055/s-0043-1770994","url":null,"abstract":"Abstract Background Of the 130 million babies born worldwide each year, an estimated 4 million die during the neonatal period. Of the total global neonatal mortality, 99% occurs in low- and middle-income countries, particularly in Africa and South Asia. The current study was designed to calculate the neonatal mortality rate (NMR), analyze the causes of neonatal deaths, and examine risk factors contributing to neonatal deaths in the neonatal unit of Tobruk Medical Center (TMC). Methods A case-control study was conducted on 180 newborns divided into two groups admitted to the neonatal intensive care unit (NICU) on the same day of delivery. The first group included 90 newborns who died before day 28 and the second group included 90 newborns who survived until the time of discharge and were selected randomly. The data of the patients were collected from the medical records of newborns admitted to the neonatal unit at TMC between July 2018 and July 2019. All data in this study were statistically analyzed using SPSS 23.0 for Windows (SPSS Inc., Chicago, IL, United States). Results The NMR among the studied neonates was 12.3 per 1,000 live births, and the death rate was 16.36% per 1,000 admissions. The most common causes of mortality were premature birth (55, 61%), birth asphyxia (18, 20%), and congenital anomalies (10, 11.2%). Less than 50% of the dead patients were on a mechanical ventilator. Premature birth and low birth weight patients are strong predictors of neonatal mortality; normal vaginal delivery had a higher risk of mortality than the other methods of delivery. Gender, maternal blood group, maternal age, and past obstetrical and medical history had no positive correlation with mortality except for antepartum hemorrhage. Conclusions The study found that the rate of neonatal mortality is similar to that of other hospitals in developing countries and the most common cause of neonatal death was premature birth, and premature birth and low birth weight were the main risk factors for death.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79768851","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}
A. Atia, Safad Mohammed, Marwa Mohammed, Ghofran Alhemmali, Samah Fayad
Abstract Background University-based research is critical for primary care, particularly in low- and middle-income countries like Libya. The current study was aimed at exploring the research productivity and potential barriers among academic medical staff at the University of Tripoli, Libya. Methods A cross-sectional questionnaire-based study was done at the University of Tripoli for the period from November 2022 to March 2023 to determine health research barriers among staff members in different medical faculties. Data collected included participant's demographics, years of experience as a faculty member, workplace, academic status, highest educational qualification, education type, and number of research studies published. Data also contained questions around personal, access, administrative, and resource barriers to and facilitators of research activity. Results A total of 132 questionnaires were distributed by the authors, of which only 102 were successfully answered, giving a response rate of 76%. The majority of participants 49 (48.04%) conducted a cross-sectional study, followed by 34 (33.3%) who carried out a review study. The most important reason of doing research was to improve knowledge of the field (62.75%), while 77.47% stated that they made use of and were comfortable using advanced technology in their research activities. The top barriers to research were a lack of financial support (76 [74.51%]), followed by the complex publication process (43 [42.16%]). Lack of writing skills (4 [3.92%]) was the bottom perceived barrier. Conclusion Faculty members at the University of Tripoli face various barriers that can impede their productivity in medical research, such as a lack of resources, and limited research opportunities. These factors, combined with a lack of support from administrators, can lead to low morale and a lack of motivation among faculty members, which can further inhibit their research productivity.
{"title":"Medical Research Productivity and Barriers from the Perspective of Faculty Members at the University of Tripoli","authors":"A. Atia, Safad Mohammed, Marwa Mohammed, Ghofran Alhemmali, Samah Fayad","doi":"10.1055/s-0043-1770993","DOIUrl":"https://doi.org/10.1055/s-0043-1770993","url":null,"abstract":"Abstract Background University-based research is critical for primary care, particularly in low- and middle-income countries like Libya. The current study was aimed at exploring the research productivity and potential barriers among academic medical staff at the University of Tripoli, Libya. Methods A cross-sectional questionnaire-based study was done at the University of Tripoli for the period from November 2022 to March 2023 to determine health research barriers among staff members in different medical faculties. Data collected included participant's demographics, years of experience as a faculty member, workplace, academic status, highest educational qualification, education type, and number of research studies published. Data also contained questions around personal, access, administrative, and resource barriers to and facilitators of research activity. Results A total of 132 questionnaires were distributed by the authors, of which only 102 were successfully answered, giving a response rate of 76%. The majority of participants 49 (48.04%) conducted a cross-sectional study, followed by 34 (33.3%) who carried out a review study. The most important reason of doing research was to improve knowledge of the field (62.75%), while 77.47% stated that they made use of and were comfortable using advanced technology in their research activities. The top barriers to research were a lack of financial support (76 [74.51%]), followed by the complex publication process (43 [42.16%]). Lack of writing skills (4 [3.92%]) was the bottom perceived barrier. Conclusion Faculty members at the University of Tripoli face various barriers that can impede their productivity in medical research, such as a lack of resources, and limited research opportunities. These factors, combined with a lack of support from administrators, can lead to low morale and a lack of motivation among faculty members, which can further inhibit their research productivity.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77244278","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}
Heba Jeroudy, M. Al-Tabakha, A. Ashames, A. Jairoun
Abstract Background The growing concern of irrational drug use that leads to adverse events requires attention to investigate the prescription patterns. For cardiovascular drugs, this could increase patients' risk of developing a heart attack or stroke and coronary artery disease. This study particularly examines cardiologist behaviors that influence prescription patterns. The influence of pharmaceutical companies' promotions and other factors affecting their prescriptions in the United Arab Emirates (UAE), mainly in Dubai and the Northern Emirates private hospitals and clinics, were investigated. Methods Online survey questions were undertaken using the structured questionnaire, and the determined sample size of the cardiologists working in Dubai and the Northern Emirates was 59 using randomly generated numbers from the available cardiologists' registry and assuming 95% confident with the 80% response rate. Ratings of the prescribing behavior were done using the original Bloom's cutoff points, which were updated and adjusted to evaluate UAE cardiologists' general prescribing practices. Results The average prescribing behavior score was moderate (76.5%; 95% confidence interval [CI], 75.1–77.8). Better prescribing patterns were observed among the cardiologists from Dubai compared with the Northern Emirates (odds ratio 4.24; 95% CI, 1.06–16.97). Continued medical education sponsored by pharmaceutical companies was the main influential factor (96.6%) affecting the cardiologists in changing their prescription. A total of 40.7% of the cardiologists believed in changing the prescription from brand to generic, while 43% stated that clinical updates, including evidence from new studies, were among the other factors affecting their prescribing behavior pattern. Conclusion The cardiologists' prescribing behaviors in Dubai and the Northern Emirates are above average and the cardiologists are aware of the unethical acceptance of pricey gifts. Cardiologists in Dubai and the Northern Emirates are considered ethical in adopting a new medication in agreement with similar studies conducted regionally, as their primary motivation is the welfare of patients, which will help them rationally select medication.
{"title":"Factors Affecting the Cardiologists' Prescribing Attitudes in Dubai and the Northern Emirates: A Cross-sectional Study","authors":"Heba Jeroudy, M. Al-Tabakha, A. Ashames, A. Jairoun","doi":"10.1055/s-0043-1768037","DOIUrl":"https://doi.org/10.1055/s-0043-1768037","url":null,"abstract":"Abstract Background The growing concern of irrational drug use that leads to adverse events requires attention to investigate the prescription patterns. For cardiovascular drugs, this could increase patients' risk of developing a heart attack or stroke and coronary artery disease. This study particularly examines cardiologist behaviors that influence prescription patterns. The influence of pharmaceutical companies' promotions and other factors affecting their prescriptions in the United Arab Emirates (UAE), mainly in Dubai and the Northern Emirates private hospitals and clinics, were investigated. Methods Online survey questions were undertaken using the structured questionnaire, and the determined sample size of the cardiologists working in Dubai and the Northern Emirates was 59 using randomly generated numbers from the available cardiologists' registry and assuming 95% confident with the 80% response rate. Ratings of the prescribing behavior were done using the original Bloom's cutoff points, which were updated and adjusted to evaluate UAE cardiologists' general prescribing practices. Results The average prescribing behavior score was moderate (76.5%; 95% confidence interval [CI], 75.1–77.8). Better prescribing patterns were observed among the cardiologists from Dubai compared with the Northern Emirates (odds ratio 4.24; 95% CI, 1.06–16.97). Continued medical education sponsored by pharmaceutical companies was the main influential factor (96.6%) affecting the cardiologists in changing their prescription. A total of 40.7% of the cardiologists believed in changing the prescription from brand to generic, while 43% stated that clinical updates, including evidence from new studies, were among the other factors affecting their prescribing behavior pattern. Conclusion The cardiologists' prescribing behaviors in Dubai and the Northern Emirates are above average and the cardiologists are aware of the unethical acceptance of pricey gifts. Cardiologists in Dubai and the Northern Emirates are considered ethical in adopting a new medication in agreement with similar studies conducted regionally, as their primary motivation is the welfare of patients, which will help them rationally select medication.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85031385","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}
Abstract A 72-year-old female was found to have symptomatic hypertrophic obstructive cardiomyopathy associated with significant aortic stenosis. She was found to have severe left ventricular outflow tract obstruction, asymmetric septal hypertrophy, significant systolic anterior motion of the anterior mitral valve leaflet, and mitral regurgitation. She was also found to have moderate aortic stenosis that made the obstruction even worse which made the patient progressively symptomatic not responding to medical therapy. She eventually underwent cardiac surgery in form of left ventricular septal myomectomy and bioprosthetic aortic valve replacement (tissue AVR) with a size 23 tissue valve, aortic root enlargement with bovine pericardial patch. She is currently stable on optimal medical therapy, feels much better and stable cardiac-wise with much better quality of life.
{"title":"Hypertrophic Obstructive Cardiomyopathy Associated with Moderate Aortic Stenosis in Symptomatic 75-Year-Old Female: A Case Report","authors":"A. Abonowara","doi":"10.1055/s-0043-57016","DOIUrl":"https://doi.org/10.1055/s-0043-57016","url":null,"abstract":"Abstract A 72-year-old female was found to have symptomatic hypertrophic obstructive cardiomyopathy associated with significant aortic stenosis. She was found to have severe left ventricular outflow tract obstruction, asymmetric septal hypertrophy, significant systolic anterior motion of the anterior mitral valve leaflet, and mitral regurgitation. She was also found to have moderate aortic stenosis that made the obstruction even worse which made the patient progressively symptomatic not responding to medical therapy. She eventually underwent cardiac surgery in form of left ventricular septal myomectomy and bioprosthetic aortic valve replacement (tissue AVR) with a size 23 tissue valve, aortic root enlargement with bovine pericardial patch. She is currently stable on optimal medical therapy, feels much better and stable cardiac-wise with much better quality of life.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88711043","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}
Hanan M. Garalla, K. M. A. Darraz, Maggdi M.A. Essa
Abstract Background Prostatic diseases such as inflammation, benign prostatic hyperplasia, and tumors are prime causes of mortality and morbidity in males. The prevalence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide. Aim The present study was undertaken with the aim of studying the clinicopathological characteristics of prostate lesions in surgical specimens Methods The present study was a retroprospective study. A total of 212 prostate surgical specimens were included. Information provided in the requisition form regarding age, type of prostatic biopsy and clinical presentation, and histopathological diagnosis was taken into consideration and recorded. All specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with hematoxylin and eosin stain (H&E stain). Relevant clinical data including age, the presenting complaints, and S.PSA values were recorded. Data were collected and analyzed using simple statistical methods with Microsoft Excel 2016. Results Out of 212 cases analyzed, 161 ( 76%) were transurethral resection of prostate (TURP) TUPR specimens, 38 (18%) were trucut needle biopsies, and 13 (6%) were open prostatectomy specimens. The youngest patient was 48 years old while the oldest patient was 90 years old with a mean of 71.7 ± 8.2 years. Of the total 212 surgical specimens, 174 (82%) cases were of benign prostatic hyperplasia (BHP), and 38 (18%) were prostatic adenocarcinoma (PAC). Also, 94 (44.3%) of BPH and carcinoma of the prostate cases were most common in the seventh decade of life ( 61-70 years ). Difficulty in micturition was the most common presentation 82 (39%). A maximum number of the BPH cases 81 (46.5%) had the prostate-specific antigen range of 0 to 4 ng/mL. The highest value of serum PSA was noted among the PAC patients in the range of > 80 ng/mL. Out of 38 cases of prostatic adenocarcinoma, moderately differentiated (Gleason scores 7) was the most common core and was seen in 42.1% of the PAC cases. Conclusion The present study showed that the most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61 to 70 years. The PAC was common among males of more than 60 years. Histopathological examination is the best diagnostic tool for PAC
{"title":"A Retroprospective Clinicopathological Study of Prostatic Lesions in Surgical Specimens","authors":"Hanan M. Garalla, K. M. A. Darraz, Maggdi M.A. Essa","doi":"10.1055/s-0042-1759622","DOIUrl":"https://doi.org/10.1055/s-0042-1759622","url":null,"abstract":"Abstract Background Prostatic diseases such as inflammation, benign prostatic hyperplasia, and tumors are prime causes of mortality and morbidity in males. The prevalence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide. Aim The present study was undertaken with the aim of studying the clinicopathological characteristics of prostate lesions in surgical specimens Methods The present study was a retroprospective study. A total of 212 prostate surgical specimens were included. Information provided in the requisition form regarding age, type of prostatic biopsy and clinical presentation, and histopathological diagnosis was taken into consideration and recorded. All specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with hematoxylin and eosin stain (H&E stain). Relevant clinical data including age, the presenting complaints, and S.PSA values were recorded. Data were collected and analyzed using simple statistical methods with Microsoft Excel 2016. Results Out of 212 cases analyzed, 161 ( 76%) were transurethral resection of prostate (TURP) TUPR specimens, 38 (18%) were trucut needle biopsies, and 13 (6%) were open prostatectomy specimens. The youngest patient was 48 years old while the oldest patient was 90 years old with a mean of 71.7 ± 8.2 years. Of the total 212 surgical specimens, 174 (82%) cases were of benign prostatic hyperplasia (BHP), and 38 (18%) were prostatic adenocarcinoma (PAC). Also, 94 (44.3%) of BPH and carcinoma of the prostate cases were most common in the seventh decade of life ( 61-70 years ). Difficulty in micturition was the most common presentation 82 (39%). A maximum number of the BPH cases 81 (46.5%) had the prostate-specific antigen range of 0 to 4 ng/mL. The highest value of serum PSA was noted among the PAC patients in the range of > 80 ng/mL. Out of 38 cases of prostatic adenocarcinoma, moderately differentiated (Gleason scores 7) was the most common core and was seen in 42.1% of the PAC cases. Conclusion The present study showed that the most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61 to 70 years. The PAC was common among males of more than 60 years. Histopathological examination is the best diagnostic tool for PAC","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84900096","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}
Abstract In recent years and for decades, antimicrobial resistance (AMR) has expanded into a major clinical issue. Infections were no longer a life-threatening issue for clinicians after the discovery of antibiotics. The misuse or overuse of antibiotics, however, contributes to global AMR, and numerous mobile genetic elements and relevant resistant genes worsen the spread of resistance. As antibiotics lose their effectiveness, a growing number of infections such as pneumonia, tuberculosis, and gonorrhea are getting harder and sometimes impossible to treat. Infections that are resistant to antibiotics are correlated with antibiotic misuse. The majority of the antibiotic resistance in microbes is caused by improper use of antibiotics. Because there are a few antibiotics available to treat multidrug-resistant bacterial infections, there is a high rate of morbidity and mortality. Libya has a high burden of antibiotic resistance, and antimicrobial malpractice has frequently been reported. Providing information on the current state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Therefore, this review highlights the current situation of bacterial profile and their antimicrobial resistance in Libya based on the source of infection. Articles related to the topic were searched using databases and search engines such as PubMed, Google Scholar, and ResearchGate websites. These articles were selected if they were conducted in Libya and provided information on bacterial pathogens and AMR. Required data were extracted for the purpose of this review report, and then further verified for identifying the prevalence and number of susceptible and resistant pathogens in each source of infection.
{"title":"Characteristics of Antibiotic-Resistant Bacteria in Libya Based on Different Source of Infections","authors":"Bushra Hosien, Howida Belhaj, A. Atia","doi":"10.1055/s-0042-1759621","DOIUrl":"https://doi.org/10.1055/s-0042-1759621","url":null,"abstract":"Abstract In recent years and for decades, antimicrobial resistance (AMR) has expanded into a major clinical issue. Infections were no longer a life-threatening issue for clinicians after the discovery of antibiotics. The misuse or overuse of antibiotics, however, contributes to global AMR, and numerous mobile genetic elements and relevant resistant genes worsen the spread of resistance. As antibiotics lose their effectiveness, a growing number of infections such as pneumonia, tuberculosis, and gonorrhea are getting harder and sometimes impossible to treat. Infections that are resistant to antibiotics are correlated with antibiotic misuse. The majority of the antibiotic resistance in microbes is caused by improper use of antibiotics. Because there are a few antibiotics available to treat multidrug-resistant bacterial infections, there is a high rate of morbidity and mortality. Libya has a high burden of antibiotic resistance, and antimicrobial malpractice has frequently been reported. Providing information on the current state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Therefore, this review highlights the current situation of bacterial profile and their antimicrobial resistance in Libya based on the source of infection. Articles related to the topic were searched using databases and search engines such as PubMed, Google Scholar, and ResearchGate websites. These articles were selected if they were conducted in Libya and provided information on bacterial pathogens and AMR. Required data were extracted for the purpose of this review report, and then further verified for identifying the prevalence and number of susceptible and resistant pathogens in each source of infection.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85708092","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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