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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 4 | Issue 2
Page Nos. 45-90

Online since Monday, December 30, 2019

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EDITORIAL  

The first PharmD program in Libya p. 45
Salma Abdelkerim Bukhatwa, Mustafa Mohamed Elfakhri
DOI:10.4103/LIUJ.LIUJ_10_19  
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ORIGINAL ARTICLES Top

Effect of diabetes on central macular thickness quantitatively measured using optical coherence tomography at Sidi-Hussein Health Center, Benghazi, Libya p. 49
Mervat A Omear, Samar A Bukhatwa, Fatma Saleh Benkhaial
DOI:10.4103/LIUJ.LIUJ_22_19  
Introduction: Diabetic macular edema (DME) is the most common cause of decreased vision in diabetic retinopathy (DR) and its detection needs equipment and skills. Optical coherence tomography (OCT) is an objective technique that can measure retinal morphologic characteristic which help improving diagnosis and treatment. Aims: This study was conducted to evaluate the role of OCT macula in the screening for DME in patients with diabetes by comparing it to clinical funduscopy in addition to assessing the relationship between central macular thickness (CMT) as measured by OCT macula and the visual acuity of patient. Settings and Design: A retrospective study was done at Sidi Hussein Health center/Benghazi in the period between 2014 and 2017. Subjects and Methods: The data of 393 (786 eyes) patients with diabetes (type II) were reviewed. Cases characteristics records were extracted in addition to fundus examination records (done by noncontact +90-diopter lens). The records of OCT (CMT) were evaluated for agreement with the subjective fundus examination and in relation to other measures. Data were presented as frequencies and the statistical analyses were performed using Statistical Package for the Social Science (Windows version 17.0; SPSS Inc., USA). Results: Around 537 eyes (82%) of eyes with mild DME as diagnosed by OCT were having no DR when examined subjectively. With OCT, it was found that 555 eyes (85%) with mild DME were having good visual acuity (logarithm of the minimum angle of resolution 0.3 and less). About 10 eyes (71%) having severe DME were having duration of diabetes of 10–20 years. Conclusions: OCT is a noninvasive method that can objectively detect and quantify early DME before it affects the vision of patients and it is strongly recommended that this should be the technique of choice for detecting and screening of DME in Libyan patients.
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A cross sectional preliminary study on the prevalence of ABO and rhesus blood groups in Bani Waleed City, Libya p. 56
Samira Daw Ameigaal, Ahmed A Ageel
DOI:10.4103/LIUJ.LIUJ_18_19  
Background: The distribution of ABO and rhesus (Rh) blood groups has been reported to be different in several world populations. There have been few studies about blood groups among Libyan population. Aims: The study aims to determine the distribution and frequency of ABO and Rh blood groups among Libyan population in Bani Waleed city. Subjects and Methods: The study group had included 344 participants of both genders aged between 15 and 80 years. Blood samples were collected for ABO and Rh blood group analysis from September to December 2018. Results: The percentage of male participants was 55.8% and 48.2% were female. The highest percentage (30.2%) were among the age group of 23–32 years. O blood group was the most common (43.6%), followed by A (31.7%), B (17.7%), and finally, AB blood group (7.0%). The percentage of Rh positive (Rh+) was 72.2% and of Rh negative (Rh) was 23.8%. Moreover, the prevalence of ABO with Rh+ was 33.4%, 27.6%, 11.3%, and 4.7% for O+, A+, B+, and AB+, respectively. The prevalence of ABO with Rh was 9.9%, 6.11%, 4.1%, and 2.6% for O, B, A, and AB, respectively. Conclusion: The distribution of ABO blood group in the present study is ordered of O > A> B > AB with majority of Rh+ and higher frequencies of Rh. The findings of this study will contribute in health services and use them as database to know detailed information of blood types such as for blood bank and blood transfusion and also to be used in population studies.
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Evolving a national preventive protocol for vertical transmission of group B streptococcus in a low-resource country: The culture-based approach p. 62
Mariam Abdulbaki, Munirdeen A Ijaiya, Abayomi Fadeyi, Omotayo O Adesiyun, Abiodun S Adeniran, Onozare F Aliyu, Abdulgafar A Jimoh
DOI:10.4103/LIUJ.LIUJ_17_19  
Objective: The study objective was to determine the role and applicability of the culture-based approach to Group B Streptococcus(GBS) screening and the effect on pregnancy outcome.Materials and Methods: This is a prospective cross-sectional study involving 166 consenting antenatal clinic attendees at 35–37 weeks' gestation using purposive sampling. All participants had vaginal and rectal swabs collected and cultured with the availability of culture results at the time of presentation in labor. All GBS-colonized mothers received intrapartum prophylaxis with parenteral antibiotics based on antibiotic sensitivity from the onset of labor or the rupture of membrane until delivery. Statistical analysis was conducted using SPSS software version 21.0, while P < 0.05 was considered statistically significant. Results: The GBS maternal prevalence was 7.8%, and culture-positive women had both vaginal and rectal colonization. Marital status (P = 0.002), multiple sexual partners (P =0.001), previous sexually transmitted infections (P = 0.013), and low socioeconomic status (P = 0.012) were significantly associated with GBS colonization. GBS isolates were 100% sensitive to ampicillin, all participants had a minimum of two doses of intrapartum prophylaxis with parenteral ampicillin, there was no maternal morbidity, and the vertical transmission of GBS was 0%. Conclusions: The culture-based approach and the culture-based maternal intrapartum prophylaxis prevented both maternal and neonatal complications from GBS. Establishing regional- and national-level preventive protocols will be a central strategy for the prevention.
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Presentation and management of postcircumcision meatal stenosis at Hawari Center, Benghazi, Libya: A clinical review of 86 cases p. 69
Muftah Hamad Elkhafifi
DOI:10.4103/LIUJ.LIUJ_24_19  
Background: Circumcision is a commonly practiced surgical procedure particularly in Islamic countries. As any other surgical procedure, it is attended by some complications of either early (e.g., bleeding) or late (e.g., meatal stenosis [MS]). Objectives: This study was designed to study the different clinical pictures, age at presentation, and management and outcome of postcircumcision MS. Patients and Methods: This is a retrospective study involving 86 children diagnosed with symptomatic MS and underwent meatotomy during the period from January 2010 to December 2018 at Hawari Center for Urology and Otolaryngology, Benghazi. The medical records of the patients reviewed included age at presentation, different clinical pictures, management, and outcomes. All patients were circumcised during the neonatal or infancy period. Results: Patients' age ranged between 3 and 13 years with a mean age of 5.14 years. More than three-quarters of the patients (84.8%) were between 3 and 8 years of age. Forty-six patients (53.4%) presented with pain (burning) during micturition; 17 patients (19.7%) with thin casting stream; 13 patients (15.11%) with thin dorsally deviated stream; five patients (5.8%) with sudden urge to micturiate; 3 (3.40%) patients with frequency of micturition; and only two patients (2.3%) with prolonged voiding time. All our patients operated by meatotomy as a day case procedure under general anesthesia, and there were no recurrences of MS symptoms in any case during the follow-up period. Conclusion: MS is a frequent late complication of neonatal circumcision; it should be excluded by careful meatal examination in any child who is circumcised particularly at the neonatal or nappy period and presented with abnormal micturition or even lower abdominal pain.
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Health professional students' preparedness for E-Health p. 74
Adel I A. Al-Tawaty, Ehab A Omar Elfallah
DOI:10.4103/LIUJ.LIUJ_25_19  
Background: E-Health is one of the recent major developments in health-care provision. Today's health professional students are considered digitally oriented, and this may endow them with the necessary capabilities to implement E-Health on graduation. Aim: This study aimed to assess students' views, use, confidence, and need for training on E-Health. Participants: Fourth-, 5th- and internship-year students of the medical and dental schools at the Libyan International Medical University constituted the study population. Methodology: This is a cross-sectional study conducted using an online administered survey. Prior to implementation, the questionnaire was reviewed by experts and then piloted on a group of research-targeted students. Likert scale was used for most questions and few were in the form of short answers. Descriptive statistics were reported using SPSS software version 23.0. Results: One hundred and two students responded, and all responders were included for most select-response questions. The male-to-female ratio was 2:3, with a mean age of 24 ± 1.8 years. Medical students accounted for 52% of the participants. An average of 45% reported proficiency in written and spoken English. Only 12% have taken IT-related courses. Their view on E-Health was moderately positive with a mean of 3.5 ± 0.34 of 3.1 ± 1.029. In spite of this, 43% ± 3.9% had negative views on E-Health. Nearly 58% of the participants used digital tools and software with a mean score of 2.43 ± 0.6. Most students reported using social media, especially Facebook (mean 4.95 ± 1.7). The students reported a confidence level of information and communication technology (ICT) use of 3.4 ± 1.2. They also described their confidence in learning a new technology with a value of 3 ± 0.3. Almost 32.9% of the participants expressed an overall need for training on ICT tools. Conclusion: The overall preparedness of this group for ICT is moderate and needs improvement. This could be achieved through introducing changes in the taught curriculum.
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Health-related quality of life of patients on antiretroviral therapy at the Federal Medical Center, Makurdi, Nigeria p. 82
Vivian N Shaahu, Wasiu O Adebimpe, Michael C Asuzu, DA Belabo, OA Popoola, O Uchendu
DOI:10.4103/LIUJ.LIUJ_26_19  
Context: Health related quality of life (HRQL) indices could provide information about the effects of disease progression and the effectiveness of medical interventions that cannot be obtained using objective clinical measures. Aim: The aim of this study is to assess HRQL of patients on highly active antiretroviral therapy (HAART) at the Federal Medical Center, Makurdi in North Central Nigeria. Settings and Design: The study was a cross-sectional survey among people living with HIV/AIDs (PLWHAs) on HAART. Methods: The 546 PLWHAs on HAART were selected using systematic sampling technique. A modification of the 36-Item Short-Form Health Survey Version 2 questionnaire was used to assess respondents' HRQL in eight dimensions: Physical functioning (PF), role-physical (RP), role-emotional (RE), social functioning (SF), bodily pain (BP), vitality (VT), mental health (MH), and general health (GH). Data generated after measuring and scoring HRQL using standard methods were analyzed using the SPSS 17. Results: Good HRQL ratings included: PF (98.9%), RE (98.7%), SF (98.2%), VT (96.9%), RP (96.5%), MH (96.3%), BP (94.1%), and GH (93.4%). Predictors of good HRQL were as follows: Age <40 years (odds ratio [OR] = 4.26, confidence interval [CI] = 1.49–12.11) and being currently employed (OR = 3.20, CI = 1.08–9.49) (RP); and having a caregiver (OR = 4.94, CI = 1.33–18.27). Predictors of less likelihood of good HRQL were: Enjoying social support (OR = 0.12, CI = 0.03–0.55) (RP; MH); being without spouse/partner (OR = 0.43, CI = 0.21–0.91) (GH). Conclusions: HAART improves HRQL of HIV patients. Clinicians need to be responsive to factors related to disclosure, having a caregiver, and social support as a means of improving HRQL.
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LETTER TO EDITOR Top

Bridging the gap to meet the global targets of water, sanitation, and hygiene services: World health organization p. 89
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/LIUJ.LIUJ_19_19  
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