Libyan Journal of Medicine最新文献

Background: Enamel defects (EDs) are commonly reported dental findings in preterm/low birthweight children. EDs potentially increase caries susceptibility.Aim: To assess the prevalence of EDs and dental caries in a group of preterm children (aged 5-10 years) in Dubai, United Arab Emirates (UAE).Methodology: A retrospective cohort study of medical records of 62 preterm children (mean age 8.1 ± 1.54) and 62 full-term children (mean age 8.1 ± 1.73) of both genders born in a UAE children's hospital were studied. These children were dentally assessed for EDs and caries by a calibrated examiner.Results: EDs were 4.34 times more prevalent among preterm children [odd ratio (OR) = 4.338, CI 95% [2.010-9.366]. The prevalence of EDs in the pre-term group was 58.15%, significantly higher (P < 0.01) than the full-term control group (24.2%). Birth weight, intubation and type of delivery were statistically significant factors contributing to EDs. In the primary dentition, the mean dmft was 4.61 ± 4.30, while in the permanent dentition DMFT was 0.38 ± 0.99. There was a statistically significant difference in permanent teeth caries experience amongst pre-term children compared to the full-term control as measured by DMFT (P = 0.008).Conclusion: EDs and dental caries in permanent dentition in the pre-term group were significantly higher than the full-term group.

The aim of this study was to assess if ureaplasmas are associated with pregnancy complications and diseases in newborns. Pregnant women with complaints and threatening signs of preterm delivery were included. A sample, taken from the endocervical canal and from the surface of the cervical portion, was sent to the local microbiology laboratory for DNA detection of seven pathogens: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Trichomonas vaginalis. The Pearson Chi-Square test was used to determine the difference in unpaired categorical data. A two-sided p value <0.05 was considered to be statistically significant. In all, 50 pregnant women with complaints and threatening signs of preterm delivery were included. Premature rupture of uterine membranes was found in 23 (46%) of the patients and 38 women (76%) had preterm delivery. Ureaplasma infections were associated with a premature rupture of membranes (p < 0.004), the placental inflammation (p < 0.025), a newborn respiratory distress syndrome (p < 0.019). Ureaplasmas could have affected the preterm leakage of fetal amniotic fluid and are associated with the placental inflammation and a newborn respiratory distress syndrome.

Introduction: Bullying is an aggressive behaviour that involves unwanted negative actions, which are repeated over time that can negatively impact a person.

Aim: To explore bullying behaviours experienced by Tanta University undergraduate students during their study in clinical medical education.

Methods: A cross-sectional study was conducted at Faculty of Medicine, during the period between first of October 2018 to end of May 2019. A stratified random sample was used to select medical students who rolled fourth-, fifth- and sixth-year classes at the academic year 2018-2019. Data were collected by a self-administered questionnaire included questions regarding demographic characteristics, history of exposure to different types of bullying and the response of bullied students.

Results: Findings of this study revealed that 71.1% of studied sample faced bullying during their medical study. The most frequently reported types were verbal (51.9%), behavioural (44.8%), being ignored (24.4%), written (17.8%) and physical (15.8%). About half of students (49.4%) were exposed to multiple forms of bullying. Male students were more exposed to physical, written and being ignored, whereas females were more witnessed to verbal and behavioural ones as follows: (30.7% vs 18.9% physical type, 72.5% vs 74.8% verbal, 28.1 vs 24.9% written, 57.9% vs 68.3% behavioural and 38.5% vs 32.4% being ignored), respectively. Fellow students (56.3%) were the most frequent perpetrators of mistreatment actions. The majority of students (91.3%) chose not to report bullying behaviours. Having mental health problems (0.00*) or disability (0.01*) were significantly more potential to experience mistreatment.

Discussion: Large proportion of medical students faced many forms of bullying.

Implications for practice: Applying an effective policy to stop bullying with support for medical students may help to minimize this phenomenon.

β-Citronellol is a monoterpene alcohol found in essential oils of various aromatic plant species. The physiological effects of β-citronellol inhalation on the central nervous system remain unclear. We investigated the effects of β-citronellol inhalation on mouse behavior. First, we examined whether the odor of β-citronellol was attractive or repellent to mice. Then, following 30 minutes of β-citronellol inhalation, a series of behavioral tests (elevated plus maze, open field, Y-maze, tail suspension, and forced swim tests) were performed. Mice were neither attracted to nor repelled by β-citronellol. Mice that inhaled β-citronellol showed an increase in anxiety-like behavior in the elevated plus maze and open field tests. Performance in the Y-maze and forced swim tests was not affected. These results indicate that β-citronellol acts on the central nervous system of mice following inhalation and increases anxiety. Essential oils and cosmetics containing β-citronellol should be used with caution.

This study was conducted to evaluate the characteristics, treatment outcome and risk factors associated with 223 drug-resistant tuberculosis (DR-TB) cases in the State of Qatar. A descriptive records-based retrospective study was conducted on patients registered at Communicable Disease Centre (CDC), Qatar to all consecutive microbiologically confirmed tuberculosis cases for the period January 2010 - March 2015. Demographic, clinical data, drug-resistance pattern of isolated mycobacteria and treatment outcome was assessed for the patient who completed their treatment in Qatar. Of 3301 patients with positive M. tuberculosis culture were analyzed; 223 (6.7%) were resistant to at least one drug. The overall prevalence of multi-d rug resistant TB (MDR-TB) was 1.2% (n = 38) of patients. A former resident of Indian sub contents was the most common demographic characteristic observed (64.1%). The outcome of treatment was assessed for 85 resistant cases with follow-up after completion of treatment. Cure and relapse rates were 97.6%, and 2.4%, respectively. Drug-resistant TB in Qatar is influenced by migration where the patients were probably infected. Rapid sputum sampling performed in the early stages of the disease, patient isolation, and drug-susceptibility testing should be the standard of care.

Knee Osteoarthritis is a considerable public health concern, both in terms of life quality and treatment financial impacts. To investigate this disease, animal models are deemed a promising alternative. In fact, although a perfect model is generally farfetched, the creation of models that simulate human disease as accurately as possible remains an important research stake. This study aims to highlight the usefulness of the model induced by injected Mono-Iodo-Acetate and to standardize it for the rabbit species. Osteoarthritis was induced by an infra-patellar injection of 0.2 ml of an MIA solution in the left knee of 24 female New Zealand rabbits. The right knee served as a control by receiving an injection of physiological serum. The rabbits were divided into 4 groups of 6 individuals each according to the dose of MIA received per knee. All rabbits were euthanized 30 days after the injection. After sacrifice, the knees were carefully dissected and macroscopic and microscopic scores of cartilage, meniscal and synovial lesions were attributed to each group. Our study followed the laboratory animal care and management guideline published in 2017 by the Canadian Council of Animal Care. The control knees of all rabbits showed no macroscopic or microscopic lesions. The macroscopic lesions: osteophytes, meniscal lesions, fibrillation and erosion of the cartilage and microscopic lesions: disorganization of the chondrocytes, decrease in proteoglycans and synovial inflammation clinically diagnosed in human pathology were all detected and were similarly reproducible among the knees of the same group. Through this work, we highlighted the merits of the arthritis model induced by MIA, namely its simulation of several aspects of human pathology. Further advantages are low cost, speed, reproducibility. This model notably avoids delicate and risky surgical operations.

We aimed to compare the efficiency of the first dose of Hepatitis B (HB) vaccine: at Birth versus at 3 months and to evaluate the efficacy of HB vaccine. We conducted a cohort study in the governorate of Monastir. Vaccinated Cohort (VC) included populations receiving the first dose at 3 months (Protocol 1), and at birth (HepB-BD) (Protocol 2). First dose was followed by at least two doses. We collected, from January 2000 to December 2017, cases diagnosed by serological markers (hepatitis B surface antigen (HBsAg) and anti-HBc). We calculated Absolute Risk (AR) per 100,000 PY and the Relative risk reduction (RRR). Twenty-five cases were notified among VC and 1501 cases among not vaccinated cohort (NVC). Twenty-three cases were notified among the cohort receiving the first dose at 3 months and two cases in Protocol 2. The AR per 100,000 PY was 5.67 (CI95%: 3.36-7.99) in Protocol 1 and 0.11 (CI95%: 0.001-0.26) in Protocol 2. The RRR was 77% (95% CI: 66; 85) in Protocol 1 and 99.4% (95% CI: 97.8; 99.9) in Protocol 2. We identified 4 HB cases for children aged between 5 and 11 who benefited from protocol 1 (born between 2000 and 2006) and zero cases for children of the same age group benefiting from protocol 2 (born between 2011 and 2017). The annual number of HB has decreased from 112 in 2000 to 48 in 2017. We predicted 40 new cases of HB in 2030. HepB-BD was 99.4% effective at preventing HB. The continuity of HepB-BD worldwide would achieve WHO's goal of eliminating HB as a threat to health by 2050.

Abbreviations: AR: Absolute Risk; ARR: Absolute Risk Reduction; G1: Group1; G2: Group2; HB: Hepatitis B; HepB-BD: Hepatitis B Birth Dose; MENA: Middle East and North Africa; NNV: Number Needed to Vaccine; HIV: Human Immunodeficiency Virus; NVC: Not Vaccinated Cohort; PY: Person Year; RRR: Relative Risk Reduction; RR: Relative Risk; VC: Vaccinated Cohort; WHO: World Health Organization.

Introduction: Clostridioides difficile (C. difficile) infection (CDI) is one of the most common healthcare-associated (HA) infections in contemporary medicine. The risk factors (RFs) for HA CDI in medical and surgical patients are poorly investigated in countries with a limited resource healthcare system. Therefore, the aim of the study was to investigate differences in patients' characteristics, factors related to healthcare and outcomes associated with HA CDI in surgical and medical patients in tertiary healthcare centre in Serbia.Materials and Methods: A prospective cohort study was conducted including adult patients diagnosed with initial episode of HA CDI, first recurrence of disease, readmission to hospital, while deaths within 30 days of CDI diagnosis and in-hospital mortality were also recorded. Patients hospitalized for any non-surgical illness, who developed initial HA CDI were assigned to medical group, whereas those who developed initial HA CDI after surgical procedures were in surgical group. The data on patients' characteristics and factors related to healthcare were collected, too.Results: During 7-year period, from 553 patients undergoing in-hospital treatment and diagnosed with CDI, 268 (48.5%) and 285 (51.5%) were surgical and medical patients, respectively. Age ≥ 65 years, use of proton pump inhibitors, chemotherapy and fluoroquinolones were positively associated with being in medical group, whereas admission to intensive care unit and use of second- and third-generation cephalosporins were positively associated with being in surgical group.Conclusions: Based on obtained results, including significant differences in 30-day mortality and in-hospital mortality, it can be concluded that medical patient were more endangered with HA CDI than surgical ones.

The operating theatre staff is exposed to various constraints such as excessive working hours, severe medical conditions and dreadful consequences in case of malpractice. These working conditions may lead to high and chronic levels of stress, which can interfere with medical staff well-being and patients quality of care. The aim of this study is toassess the impact of music therapy on stress levels and burnout risk on the operating room staff. This is a pre-experimental study including the operating rooms staff of urology and maxillofacial surgery in the academic hospital of Sahloul Sousse (Tunisia) over a period of six weeks. The study consisted of three phases. The first was an initial assessment of stress level with a predefined survey. The second included three music therapy sessions per day over one month. The third was an immediate stress level reassessment following the intervention. Stress levels were evaluated using the Perceived Stress Scale version PSS-10 and the Maslach Burnout Inventory. The overall response rate was 73.9%.The average age of the study population was 37.8 ± 7.7 years with a female predominance (64.7%). After the music therapy program, Perceived Stress Scale average score decreased from 22 ± 8.9 to 16 ± 7.9 (p = 0.006). Concerning the burnout, only the average score of emotional exhaustion decreased significantly from 27 ± 10.8 to 19.2 ± 9.5 (p = 0.004). Music therapy is an innovative approach that seems to reduce operating theatre staff stress. It must be considered as a non pharmacological, simple, economic and non invasive preventive tool.

The administration of therapeutic agents is difficult in many patients, such as patients with post-operative delirium or dementia or patients with schizophrenia, who are upset in an emergency room. Therefore, the development of a new method for administering therapeutic agents to the central nervous system is desired. In this study, we investigated if inhalation was an effective route of administration for haloperidol, a commonly used, strong antipsychotic. Dizocilpine, also known as MK-801, is a noncompetitive antagonist of the N-methyl-D-aspartate receptor. MK-801 or memantine-induced motor hyperactivity was evaluated in mice following either intraperitoneal injection or inhalation of haloperidol or the histamine neuroactivator betahistine. Pretreatment with haloperidol inhalation inhibited the MK-801-induced or memantine-induced increase in locomotor activity. This effect was similar to that of the intraperitoneal administration of haloperidol. However, pretreatment with inhaled betahistine or the intraperitoneal administration of betahistine did not suppress the MK-801-induced or memantine-induced increase in locomotor activity. Thus, haloperidol when inhaled acts on the central nervous system of mice and suppresses the MK-801-induced increase in mouse locomotor activity. Our findings suggest that inhalation may be a novel method for administering haloperidol.

Abbreviations: ANOVA: analysis of variance.