Libyan International Medical University Journal最新文献

{"title":"Corneal Endothelial Morphological Alterations in Type 2 Diabetes: Associations with Glycemic Control, Disease Duration, and Diabetic Retinopathy Severity—A Cross-Sectional Study in Benghazi, Libya","authors":"Nadia Abdelsalam Geilani, Gemma Julio, Majdi Abdulhamid Abdala","doi":"10.1055/s-0043-1777117","DOIUrl":"https://doi.org/10.1055/s-0043-1777117","url":null,"abstract":"Abstract Background  The corneal endothelium is essential for maintaining corneal transparency and fluid regulation, and its dysfunction can lead to corneal edema and decreased visual acuity. Corneal specular microscopy is used to detect corneal disorders early. Aim  This study aimed to evaluate morphological changes in the corneal endothelium of patients with type 2 diabetes mellitus (DM) using specular microscopy. Methods  This study enrolled 50 individuals with type 2 diabetes and 50 nondiabetic individuals as control subjects. Patients with certain ocular and systemic conditions were excluded. The collected data included demographic information, medical history, recent hemoglobin A1c (HbA1c) values, visual acuity, ophthalmological examination, and diabetic retinopathy (DR) staging. The corneal endothelial morphology was evaluated using a noncontact specular microscope, which measured corneal endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variation of cell size (CV), and hexagonality. The data were analyzed using SPSS software, and the results were presented as mean ± standard deviation, numbers, and percentages. An unpaired t -test was used to compare different means, and a p -value less than 0.05 was considered statistically significant. Results  A majority of diabetic patients (62%) had diabetes for more than 10 years, and 58% of them had higher than 7.5% HbA1c levels. In terms of DR severity, 46% of patients had mild nonproliferative diabetic retinopathy (NPDR), 36% had moderate NPDR, and 10% had severe NPDR. There were significant differences between diabetic and nondiabetic groups in corneal ECD (2480 ± 223 cells/mm 2 for DM group vs. 2652 ± 234 cells/mm 2 for non-DM), hexagonality (39.6 ± 2.8% for DM group vs. 47 ± 2.1% for non-DM), CV (42 ± 2.9% for DM group vs. 35.5 ± 2.3% for non-DM), and CCT (550 ± 14.8 µm for DM group vs. 530 ± 9.6 µm for non-DM). Patients who had diabetes for more than 10 years had significantly lower ECD (2356 cells/mm 2 vs. 2689 cells/mm 2 ), lower hexagonality (39 vs. 41%), and higher CV (43 vs. 41%) and higher CCT (553.9 ± 4.6 vs. 545.5 ± 4.0) than those with less than 10 years of diabetes. As the severity of DR increased, there was a significant decrease in ECD (from 2641 ± 194 cells/mm 2 for mild NPDR to 2310 ± 82 cells/mm2 for severe PDR), a decrease in hexagonality (from 40.9 ± 3.2% for mild PDR to 37.4 ± 1.1% for severe PDR), an increase in CV (from 40.1 ± 2.3% for mild PDR to 44 ± 2.9% for severe PDR), and an increase in CCT (from 543.7 ± 13.8 for mild PDR 563.8 ± 2.9 for severe PDR). Conclusion  This study revealed that type 2 diabetes is associated with significant reductions in ECD and hexagonality, as well as an increase in CV and CCT. The severity of DR and the duration of diabetes were correlated with changes in these parameters. These findings underscore the need for a comprehensive evaluation of corneal health in diabetic patients.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944038","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":"Medical Students' Performances Using Different Assessment Methods during the Final Examination in Internal Medicine at the University of Benghazi, Libya","authors":"Najat Buzaid, Sami A. Lawgaly, Saleh M. Alawgali, Amina Albash, Mousa Alfakhri","doi":"10.1055/s-0043-1776309","DOIUrl":"https://doi.org/10.1055/s-0043-1776309","url":null,"abstract":"\u0000 Background Distinctive evaluation tools assess diverse fields of learning that considerably impact the learning process.\u0000 Objective To compare and correlate the performances of undergraduate final year medical students in written, clinical, and viva examinations in the subject of internal medicine.\u0000 Methods This is a retrospective study. After authority approval, data was collected from final year examination results during 2019 to 2020. All the students of the medical school at University of Benghazi were included in this study. Their gender and their written, clinical, viva, and total scores were included. Data were coded and transferred from Excel to SPSS version 24 and expressed as frequencies and percentages. Chi-squared analysis was performed to test for differences in the proportions of categorical variables between two or more groups. Odd ratio (OR) is used to calculate the odds of passing the subject based on scores in different types of exams. Person's correlation (R) is used to evaluate the consistency of students' performances in different examinations. A p-value of less than 0.05 was considered the cut-off value of significant.\u0000 Results The total number of students was 679, out of which 499 (73.5%) were females and 180 (26.5%) were males. The total number of students who passed the course was 422 (62%) with no significant differences between males and females. A statistically significant (p < 0.001) greater percentage of students achieved a passing score in clinical assessment (502 [73.9%]), followed by viva assessment (458.0 [67.5%]). The students performed the worse in written examination with only 291/679 (43%) students passing the examination, with no gender-based differences. There was a highly significant association between the total score of students who passed the subject and their scores in the written examination with an OR of 2.3 (p < 0.001). Viva examination and total score OR was 0.79 with no significant differences for males or females. On the contrary, there was a statistically significant negative association between clinical exams and total scores of students who passed the subject (OR = 0.58). There was a highly significant correlation (p < 0.001) between written examination and viva examination (R = 0.638), between written examination and clinical examination (R = 0.629), and between clinical and viva examinations (R = 0.763).\u0000 Conclusion Students demonstrated higher performance on clinical and viva exams compared with written exams. Additionally, there were no notable disparities in results between male and female students across any of the three exam types. The written exam served as the most reliable indicator of a student's success in the subject. Furthermore, the data revealed a positive correlation between scores on the different exam formats, indicating that students exhibited consistent performance across all modes of evaluation.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004057","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":"Efficacy and Safety of Holmium Laser Lithotripsy for Renal Calculi in Retrograde Intrarenal Surgery: A Comparative Study in Libyan Patients","authors":"Abubaker Abushnaf, Ibrahim Garta, Ali bin Omran, Anas Aboshnaf","doi":"10.1055/s-0043-1777118","DOIUrl":"https://doi.org/10.1055/s-0043-1777118","url":null,"abstract":"\u0000 Background Kidney stones are a common problem that can be treated by different surgical methods. The choice of treatment depends on the stone and patient characteristics and the local resources and skills of the urologists.\u0000 Aim The aim of this study was to evaluate the outcomes regarding the safety and effectiveness of retrograde intrarenal surgery (RIRS) using holmium laser lithotripsy for kidney stones sizes of less than or equal to 20, and more than 20 mm.\u0000 Methods The study was conducted on 54 patients with renal calculi at a single center using RIRS and holmium lithotripsy from April 2022 to April 2023. Stone size was calculated by summing up the diameters of all renal calculi, and stone-free rate (SFR) was defined as no stone or stone fragment less than 1 mm in the kidney. Results are described as mean ± standard deviation, frequency, and percentages. Chi-squared or unpaired t-tests are used for comparison between different groups as appropriate. A p-value less than 0.05 is considered significant.\u0000 Results The mean intrarenal stone size was 17.8 ± 7.6 mm, with a significant difference in stone size less than or equal to 20 mm and stone size more than 20 mm (19 ± 4.7 and 35 ± 4 mm, respectively). The main operation time was 66 ± 36.5 minutes, with significantly longer operation time for patients with kidney stones more than 20 mm (94.9 ± 34.5 vs. 49 ± 26 for stone size ≤20 mm). There was no difference in the length of stay after operation between the two different stone sizes. The overall immediate SFR was 64.4%, where stone size less than or equal to 20 mm showed a significantly higher SFR (83%) than SFR for stone size more than 20 mm (31%). This SFR increased to 91.1% 1 month later, with 100% clearance for stones size less than or equal to 20 mm compared with only 68% for stones size more than 20 mm. The overall complication rate was 9.2%, most of them were due to urinary tract infections (5 cases) that required intravenous antibiotics. Stone size had no significant effect on the complication rate. There was no significant difference in SFR between lower calyceal stone and other sites of stone.\u0000 Conclusion RIRS combined with holmium laser lithotripsy is a valuable treatment option for patients with renal stones particularly for patients with stones size of less than or equal to 20 mm with a relatively low rate and severity of complications.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003891","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":"Ruptured Subcapsular Liver Hematoma: A Rare Complication of HELLP Syndrome","authors":"Abtisam Alharam, Tawfik Abuzalout, Haitham Elmehdawi","doi":"10.1055/s-0043-1776339","DOIUrl":"https://doi.org/10.1055/s-0043-1776339","url":null,"abstract":"Abstract This case report highlights the rare and life-threatening complication of ruptured subscapular liver hematoma in the setting of hemolysis, elevated liver enzymes, and low platelets syndrome, a complication associated with pre-eclampsia. A 30-year-old pregnant woman at 38 weeks of gestation presented with high blood pressure, exaggerated neurological reflexes, and high levels of albumin in her urine. Her condition deteriorated over time, and liver function tests revealed elevated readings. An emergency cesarean section was performed, during which a large liver tear with active bleeding and rupture of the liver capsule in the right lobe were discovered. An exploratory laparotomy revealed a massive hemoperitoneum with active bleeding, and hepatic packing was performed using three gauzes. Despite this, the patient's liver parameters continued to worsen, and she was transferred to the intensive care unit for further resuscitation. After 72 hours, she underwent a second operation to remove the gauze packing, and hemostasis was successfully achieved without any active bleeding. Early detection of ruptured subcapsular liver hematoma and a coordinated approach involving medical, obstetrical, radiology, and surgical teams can lead to successful treatment of this rare and dangerous complication.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004151","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":"Ectopic Spleen in the Pelvis: A Case Report","authors":"Abdelhakim Algheryani, Sarah Muftah Younis","doi":"10.1055/s-0043-1771360","DOIUrl":"https://doi.org/10.1055/s-0043-1771360","url":null,"abstract":"Ectopic spleen is a rare clinical condition characterized by splenic hypermobility caused by elongation or mal-development of the suspensory ligaments leading to the presence of spleen outside of its normal position. It is most commonly presented in children younger than 1 year and in females of childbearing age. A 34-year-old woman underwent magnetic resonance imaging (MRI) after suspicion of uterine fibroids. The patient only complained of a painless lower abdominal mass. MRI revealed the enlarged spleen in the pelvic area, measuring 17 × 4.6 cm, suspended by elongated, dilated, and tortuous pedicle in the absence of the spleen in its normal position. Multiple factors could be attributed to the development of an ectopic spleen. These include the following: (1) congenital anomalies in the development of the dorsal mesogastrium and the absence or malformation of the normal splenic suspensory ligaments, (2) acquired conditions such as splenomegaly and pregnancy. An ectopic spleen can present in a variety of ways clinically. It might pass unnoticed throughout life. However, ectopic spleen should be considered in the differential diagnosis of patients presented with an abdominal mass. Imaging modalities are used to make a final diagnosis. The treatment choice for an ectopic spleen is splenopexy. Splenectomy is only necessary in case of an infarction.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135345251","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":"Can a Single Glomerulus Morphology Implicate Successful Therapy?","authors":"Mohamed O. Ezwaie, Sabah M. Elbarasi, Huda A. Shawish","doi":"10.1055/s-0043-1771361","DOIUrl":"https://doi.org/10.1055/s-0043-1771361","url":null,"abstract":"Recurrent gross hematuria of glomerular origin is frequently encountered in clinical practice, and in absence of specific serological marker, renal biopsy is mandatory to address the definitive diagnosis, and set out an appropriate therapeutic protocol. Technical deficiencies associated with practice of renal biopsy are frequently encountered, as inadequate number of glomeruli or poor immunofluorescence staining of kidney biopsy specimen; however, these deficiencies can be offset by detailed electron microscopy analysis of a single abnormal glom. We present a single middle-aged Libyan woman, with a rare glomerular disease, related to abnormal activation of alternative complement pathway, where renal biopsy report was initially not adequate and lacking immunohistochemistry workup. However, electron microscopy reports a characteristic abnormal glomerular deposit, coupled with clinical and biochemical data that guided our therapeutic protocol. In a middle-aged female who presented with recurrent gross hematuria and nephrotic range proteinuria, we should suspect a glomerular pathology. Further to immunoglobulin A nephropathy or lupus nephritis, particularly in presence of complement abnormalities and negative serology for glomerulopathy-related autoantibodies, dense deposit disease and C3 glomerulonephritis that are rare complement mediated glomerulopathy should be considered as a seronegative lupus nephritis-equivalent, in terms of their membranoproliferative features on light microscopy, and when setting out appropriate therapeutic protocol. Patient and family counseling for C3 glomerulopathy is essential because this type of glomerulopathy has a recurrence rate after kidney transplant.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135385525","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":"Substandard and Falsified Medical Products: Time to Arrest Their Growth","authors":"S. Shrivastava, Rasdita Nurhidayati","doi":"10.1055/s-0043-1771359","DOIUrl":"https://doi.org/10.1055/s-0043-1771359","url":null,"abstract":"","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82072141","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":"Congenital Retinal Macrovessel. A Case Report of a Rare Incidental Finding","authors":"S. Bukhatwa, Mervat A. Omear","doi":"10.1055/s-0043-1771178","DOIUrl":"https://doi.org/10.1055/s-0043-1771178","url":null,"abstract":"Abstract Congenital retinal macrovessel (CRM) is a rare vascular abnormality of the macular region that is usually discovered incidentally. We present the case of a 57-year-old Libyan female patient with a CRM. The patient's left eye showed an abnormally large retinal vein crossing the foveal avascular region, Optical coherence tomographic angiography (OCTA) showed a large retinal vessel in the left eye branching superiorly at the edge of the fovea a vascular zone. The patient has no visual defect or macular thickening. CRM is an incidental finding that, with rare exceptions, does not cause any alteration to the patient's vision. They can be imaged by OCTA and need to be differentiated from other retinal pathologies.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85345914","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":"Importance of Establishing National Academic Reference Standards in Medical Education in Libya","authors":"Abdalla Salem Elhwuegi","doi":"10.1055/s-0043-1776310","DOIUrl":"https://doi.org/10.1055/s-0043-1776310","url":null,"abstract":"","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365734","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":"An Investigation into the Fast-Food Consumption Habits of Public Health and Nursing Students at the University of Sunderland in London, UK","authors":"Sauda Parvin, Russell Kabir, A. Parsa, Madhini Sivasubramanian","doi":"10.1055/s-0043-1776398","DOIUrl":"https://doi.org/10.1055/s-0043-1776398","url":null,"abstract":"Abstract Background  It is generally believed that university students may consume nutritionally deprived foods, which can lead to weight gain and long-term health complications. Aims  This research aims to illustrate the fast-food consumption pattern of nursing and public health students at the University of Sunderland in London, United Kingdom. Methods  This cross-sectional study involved 235 nursing and public health students. The survey included a validated questionnaire, which provided insights into the general characteristics of the participants, their fast-food consumption patterns, reasons for fast-food consumption, and knowledge about fast food. The data was analyzed using SPSS version 21, chi-squared tests conducted to determine the significance of the relationships between different variables. Odds ratio (OR) was utilized to assess the association between two variables. Results  About 50.6% of the students were aged between 20 and 29 years, and 77.4% patients were female, 46.8% single, and 31.1% unemployed. About 26.4% of the students were overweight, and 14.5% were obese. Fast-food consumption occurred during lunchtime (48.1%), followed by evening (37.0%). OR for fast-food enjoyment decreased significantly with age (from 0.54 for the age group 30–39 years old to only 0.13 in the age group 50–59). Married individuals were less likely to enjoy fast food than single nurses (OR = 0.54). Body mass index (BMI) was positively and significantly associated with fast-food enjoyment, with the OR increasing significantly with increasing BMI (from 5.9 for the BMI 18–24 kg/m 2 up to 11.6 for BMI above 30 kg/m 2 ). Females were more likely to enjoy the taste of fast food than males (48.4 vs. 32.1%). Males were more likely to favor fast food than females due to lack of cooking skills (7.5 vs. 1.6%), to save time (47.2 vs. 30.2%), and to fulfill their basic needs (26.4 vs. 11%). About 96.2% of females and 92.5% of males acknowledged that excessive consumption of fast food could lead to health problems. Conclusion  Fast-food consumption exhibited variability among university students, with females being more inclined toward the taste and males toward convenience. Age exhibited a negative association, while BMI displayed a positive association with fast-food enjoyment. Both genders acknowledged that excessive consumption of fast food could lead to health issues.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364956","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}