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   Table of Contents - Current issue
Coverpage
July-December 2018
Volume 3 | Issue 2
Page Nos. 31-70

Online since Wednesday, December 19, 2018

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REVIEW ARTICLES  

Impact of chronic stress on cardiovascular system: Libyan conflict health perspective. Part one: Types of chronic stresses p. 31
Abdalla Salem Elhwuegi, Lamis Ali Teebar
DOI:10.4103/LIUJ.LIUJ_25_18  
Recent studies have provided clear and convincing evidence that chronic stress contributes significantly to the pathogenesis and expression of cardiovascular diseases (CVDs). This bibliography is a systematic review on the impact of chronic stress on the cardiovascular system with a special reflection on the Libyan conflict. It is divided into two parts, Part 1 deals with types of chronic stresses, while Part 2 deals with mechanisms involved in chronic stress and their treatments. Medline/PubMed, Google Scholar, and Scopus databases were used to search for peer-reviewed papers dealing with the review theme. Stress can be classified into acute stress and chronic stress. Chronic stress can stem from underlying factors such as economic stress, social isolation stress, posttraumatic stress, and job strain stress. Economic stress is emerging as an important determinant of perceived health where different studies have found an inverse trend between risk factor burden and cardiovascular disease prevalence in urban and rural communities in high-, middle-, and low-income regions. Social stress is another factor that has been reported to be associated with a 2–3 fold increase in the incidence of CVD. Moreover, multiple studies have shown that patients suffering from posttraumatic stress disorder have increased resting heart rate, increased startle reaction, and increased blood pressure as responses to traumatic events. CVD is one of the health outcomes whose links with work stress have been well established based on numerous prospective studies.
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Impact of chronic stress on cardiovascular system: Libyan conflict health perspective part 2: Mechanisms and treatment strategies p. 36
Abdalla Salem Elhwuegi, Lamis Ali Teebar
DOI:10.4103/LIUJ.LIUJ_26_18  
Recent studies have provided clear and convincing evidence that chronic stress contributes significantly to the pathogenesis and expression of cardiovascular diseases (CVDs). This bibliography is a systematic review on the impact of chronic stress on the cardiovascular system with a special reflection on the Libyan conflict. It is divided into two parts, Part 1 deals with types of chronic stresses, while Part 2 deals with mechanisms involved in chronic stress and their treatments. Medline/PubMed, Google Scholar, and Scopus databases were used to search for peer-reviewed papers dealing with the review theme. Mechanisms responsible for the development of chronic stress are either behavioral or biological. Behavioral factors include lifestyles (e.g., smoking, alcohol, and physical inactivity). Biological mechanisms include sympathetic overdrive, hypothalamic–pituitary–adrenal axis overactivity, and low activity of central gamma-aminobutyric acid. Chronic stress managements and treatment strategies include psychological treatment like cognitive behavioral interventions, breathing techniques like Yoga and/or pharmacological treatments like selective serotonin reuptake inhibitors, and drugs that inhibit sympathetic hyperactivity.
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ORIGINAL ARTICLES Top

The physical, chemical, and microbiological stability of chloramphenicol ophthalmic solution Highly accessed article p. 42
Tauwfik Mohamed Salih, Idris Mohamed El-Mahdi
DOI:10.4103/LIUJ.LIUJ_16_18  
Aims: The aim of this work is to “predict” the remaining shelf-life of chloramphenicol (CH) eye drops, commercially marketed, using the theoretical “Longland–Rowbotham model,”” followed by confirmation of findings by practical means. Materials and Methods: The methods used for the evaluation of CH-eye drops included the assay of the active ingredient, sterility testing, and minimum inhibitory concentration (MIC) determination using official methods during 6 months stability study at variable temperatures (4, 25°C). Furthermore, a 3-month accelerated stability study was carried out. Statistical analysis tests included Student's t-test and analysis of variance. Results: The prediction model indicated that in pessimistic conditions, the remaining shelf life was reduced to a merely 1 month following production (this is versus the 2 years expiration date given by manufacturer). However, the samples analyzed throughout a 6-month stability study revealed that storing CH solution at 4°C or 25°C does not produce any statistical difference regarding drug content, MIC, or sterility. Accelerated stability studies for 3 months period showed that only after 2 months from storage at 55°C the drug will start to degrade and a statistical difference could be observed. Conclusion: Storing CH-eye drops at room temperature for up to 6 months appears to have no effect on the stability of this antibiotic.
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The effects of preoperative pregabalin administration on postoperative pain on Libyan patients undergoing laparoscopic cholecystectomy p. 49
Munira Ali Elmansouri, Aisha Mohamed Dugani, Salah Ahmed Adala
DOI:10.4103/LIUJ.LIUJ_21_18  
Objective: The present prospective study was carried out in Surgical Department of Tripoli Central Hospital with the aim to evaluate the effect of preoperative single dose of 150 mg pregabalin in reducing postoperative pain and analgesic consumption after laparoscopic cholecystectomy. Patients and Methods: Sixty patients of both sexes in the age of 18–60 years undergoing laparoscopic cholecystectomy were randomly allocated into two equal groups of 30 patients each. The pregabalin group received 150 mg oral pregabalin 1 h before induction of anesthesia and a placebo group received a matching placebo orally. Variables measured included age, sex, body mass index (BMI), duration of surgery, time to first dose and total dose of meperidine after recovery, and the visual analog scale (VAS – static and dynamic). The occurrence of nausea and vomiting during the first 24 h postoperative was also recorded. Results: No significant difference was found between the meperidine and the placebo groups regarding age, sex, BMI, or duration of surgery. The time of first meperidine dose required to alleviate pain after surgery was significantly four times longer in the pregabalin group as compared to the placebo group. The total dose of meperidine required for pregabalin group was significantly lower than that required for placebo group. Moreover, VAS was significantly decreased in the pregabalin group compared to placebo group both at static and dynamic states only 1 h after recovery. Conclusion: This study validates the preoperative use of a single dose of pregabalin in attenuating pain intensity postoperatively and reducing total analgesic consumption.
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Prevalence and types of bacterial infections of the upper respiratory tract at a tertiary care hospital in the City of Tripoli p. 54
Ahmed Atia, Ahmed Abired, Anees Ammar, Najla Elyounsi, Abdulsalam Ashour
DOI:10.4103/LIUJ.LIUJ_23_18  
Aim: The study aimed to determine the bacterial etiology of upper tract respiratory infection in Abu-Sitta Hospital, Tripoli, Libya. Subjects and Methods: A total of 470 sputum specimens and 60 throat swabs were collected over a period of 1 year (From January 2014 to December 2014) from patients presented with clinical signs of upper respiratory tract infection at Abu-Sitta Hospital. Enrolled patients were sorted as inpatients or outpatients and by gender. Data were entered and analyzed using SPSS version 22.0. Variables were expressed as percentages. Differences in age and gender were analyzed using Chi-square test. Results: Of the total 530 screened samples, 80.5% were culture positive, where bacterial pathogens were detected in 83.7% of sputum specimens and in 56.5% of throat swabs. Streptococcus pneumoniae was the most prevalent (48%), followed by Pseudomonas aeruginosa (23%), Staphylococcus aureus (13%), Enterobacter (8%), Citrobacter freundil (5%), and latest with Klebsiella (3%). Conclusions: The spectrum of pathogenic bacterium causing upper respiratory infection in Abu-Sitta Hospital is considerably wide, with S. pneumoniae and P. aeruginosa being the major causative bacteria.
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Sexual functions of female patients with chronic liver disease from two centers in Nigeria p. 59
Olusegun Adekanle, Samuel Anu Olowookere, Oluwasegun Ijarotimi, Dennis Ndububa, Oladele Oluwafemi Ayodeji
DOI:10.4103/LIUJ.LIUJ_24_18  
Background: Chronic liver disease (CLD) is a disease with significant morbidity and mortality in Nigeria. This study assessed the sexual functions of women with chronic hepatitis B infection (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC) designated as cases and normal women as controls. Methods: A prospective, comparative, case–control study of CHB, LC, HCC, and controls. Consenting cases and controls completed a self-administered Female Sexual Function Questionnaire (FSFI). Bio-data was obtained for all participants and cases were graded using the Child–Turcotte–Pugh scores (CTP). Data obtained were entered into SPSS version 20 and analyzed using descriptive and inferential statistics. Results: A total of 176 women completed the study, comprising 88 cases and 88 controls. Mean age (standard deviation) was 39.5 + 8.5 years and 40.5 + 8.2 years for cases and controls, respectively. Cases comprised CHB – 46, LC – 25, and HCC – 17, and their CTP classes were CTP A, 54; CTP B, 22; and CTP C, 12. The FSFI scores for CHB compared with controls were not statistically significant in all domains of the FSFI. The FSFI scores for LC and HCC in all domains were statistically significant compared with controls. Total mean FSFI scores for cases in CTP Class C showed sexual dysfunction, where 13.6% of CLD and 6.8% of all participants had sexual dysfunction and none among the controls. Conclusions: Females with advanced CLD had sexual dysfunction. Sexual concerns of females with CLD should be inquired for and treated.
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New experience in cochlear implantation at Benghazi Medical Center p. 65
Agila Al-Barasi, Yosef Hassan S. Abdulkarim
DOI:10.4103/LIUJ.LIUJ_15_18  
Aims: Deafness is a pathology that interferes in several aspects of the emotional, psychological, social, and intellectual life. Cochlear implants are electronic devices that allow hearing rehabilitation. This study is carried out to show our experience in cochlear implantation at Benghazi Medical Center, Libya. Patients and Methods: A retrospective descriptive study was performed over 110 patients at the Otorhinolaryngology Department, Benghazi Medical Center, between August 2012 and April 2016. The patients were analyzed according to the age, sex, type of implant inserted, approach, and intraoperative and postoperative complications. Two types of implant devices were used: cochlear and MED-EL. Surgery was done by the same surgical team. Results: Seventy of all patients operated for cochlear implantation were male (63.6%), while forty were female (36.4%). One hundred and four (94.5%) were children and 6 (5.55%) were adults. One hundred (91%) cases were prelingually deaf and 10 (9%) were postlingual deafness. Telemetry showed satisfactory neural response in 107 (97.35) cases. Failure to insert the electrode in 1 (0.9%) case as the cochlea was ossified bilaterally. Extrusion of the receiver took place in 1 (0.9%) case. One (0.9%) patient had extrusion after 2 years; another 1 (0.9%) had wound dehiscence. Despite our few years of experience in cochlear implantation, we have achieved the requirement of our patients. The need for structured services and trained professionals in this type of procedure is clear.
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LETTERS TO THE EDITOR Top

Is metabolic syndrome truly prevailing in nondiabetic Libyan women p. 69
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/LIUJ.LIUJ_39_18  
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Feedback role in enhancing the professional growth of the medical student and the teacher p. 70
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/LIUJ.LIUJ_30_18  
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