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   Table of Contents - Current issue
Coverpage
January-June 2021
Volume 6 | Issue 1
Page Nos. 1-54

Online since Monday, June 21, 2021

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GUEST EDITORIAL  

Libya, COVID-19, health diplomacy, and COVAX p. 1
Reida Menshawe ElOakley, Haider El Saeh
DOI:10.4103/liuj.liuj_55_21  
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REVIEW ARTICLES Top

Suicide terrorism and psychology of suicide bomber p. 6
Mehmet Nesip Ogun
DOI:10.4103/liuj.liuj_47_20  
This article reviews suicide terrorism and existing understandings of the psychology of suicide bomber. Suicide attacks that take place in many different parts of the world are one of the most used methods by the terrorist organizations. Suicide terrorism as a type of terrorism carried out by suicide bombers wearing bomb vests or by assembled bomb vehicles attracts a lot of attention globally. Throughout human history, some people may attempt suicide at some point in their lives, and some of these attempts end in death. Suicide is an act of self-punishment and deliberate separation from the world. In other words, suicide is a pathological behavior that a person consciously does with the aim of ending his life and ends with success. The act of killing one's own life, which a person cannot make sense of and regards as abnormal, is such a complex and painful event. In this study, terror, suicide terrorism, suicide bombing will be studied, and the psychology of the suicide bomber will be examined.
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Diabetic peripheral neuropathy: A systematic review of Nigerian patients p. 12
Taoreed Adegoke Azeez, Emmanuel Chinedu Eguzozie, Oladotun Victor Olalusi
DOI:10.4103/liuj.liuj_62_21  
Diabetes mellitus is associated with microvascular and macrovascular complications. Diabetic neuropathy is the most common long-term complication of diabetes. The study was aimed at determining the prevalence of diabetic peripheral neuropathy and identifying its associated factors. Medical databases, including PubMed, Google Scholar, African Journal Online, and SCOPUS were searched and eligible studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses algorithm. The prevalence of diabetic peripheral neuropathy in Nigeria was dependent on the modality used in diagnosing peripheral neuropathy. The overall prevalence of diabetic peripheral neuropathy in Nigeria was 31.2%–97.5%. The modality-dependent prevalences were 37%–97.5% (by biothesiometry), 41.7%–75% (by Michigan Neuropathy Screening Instrument), 31.2%–43.3% (by United Kingdom screening test), and 43.3%–69.9% (by diabetic neuropathic examination score). The associated factors were duration and control of diabetes, the age of the patient, presence of cardiovascular risk factors such as hypertension and dyslipidemia and other microvascular complications (e.g., diabetic retinopathy and nephropathy). The prevalence of diabetic peripheral neuropathy was found to be high in Nigeria and the associated risk factors were age, glycemic control, and cardiovascular risk factors.
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ORIGINAL ARTICLES Top

Knowledge, attitude, and practice of sudanese pharmacists toward COVID-19 in Khartoum State, Sudan: An online-based cross-sectional study p. 19
Safaa Badi, Abdalrahman B Hamed, Mohammed S Abualama, Mohammed A Mustafa, Muhammad Abdou Abdulraheem, Bashir Alsiddig Yousef
DOI:10.4103/LIUJ.LIUJ_42_20  
Background: COVID-19 disease became an outbreak declared by the WHO as a public health emergency that is explicitly threatening the globe. Measures must be taken to control it, and health-care workers' situations need to be assessed. Objectives: The study aimed to assess the knowledge, attitude, and practice of Sudanese pharmacists regarding COVID-19. Materials and Methods: The study was an online descriptive cross-sectional survey, conducted from April to June 2020, among the registered pharmacists in Khartoum, Sudan. Three hundred fifty registered pharmacists were asked to participate in this study, all of them were responded. An online standardized questionnaire was conducted, and data were collected by a convenience sampling method and analyzed using the Statistical Package for the Social Science. Descriptive and inferential statistics were performed. Results: Response rate was 100%, 65,7% of the participants were females. The median age was 27 years, 72.9% of the pharmacists were bachelor degree holders, and 73.1% of participants were community pharmacists. The years of experience were 1–5 years for 54.4% of them. About 69.4% of the participants had sufficient knowledge about COVID-19, 27.1% reported a positive attitude, and 62.6% reported a fair attitude. Moreover, 88.3% of them were wearing facemask, gloves, and frequently use sensitizers. Nearly 47.7% stated that they would not dispense any treatment of COVID-19 without a prescription. Tests revealed that knowledge was statistically significant with gender (P = 0.001) and attitude with age and years of experience (P = 0.039, 0.01), respectively. Conclusions: More than two-third of the participants have sufficient knowledge regarding COVID-19. Only one-tenth of them have a negative attitude, and their practice toward the disease was relatively good.
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Demographic characteristics and clinical manifestations of interstitial lung disease with systemic sclerosis in eastern part of Libya Highly accessed article p. 27
Fathi M Elbraky, Khaled D Alsaeiti, Fathiyah S M Aboulqasim, Saleh M Alawgali
DOI:10.4103/liuj.liuj_51_20  
Introduction: Pulmonary involvement, such as Interstitial Lung Disease (ILD) and Pulmonary Hypertension (PH ), accounts for significant morbidity and is the leading cause of Systemic sclerosis (SSc)-related morbidity and mortality. The aim of the current study was to study the frequency of occurrence of ILD in SSc and to describe the clinical and radiological picture of pulmonary involvement in SSc. Patients and Methods: Forty patients attending different rheumatology clinics in eastern part of Libya between January 2018 and September 2020 were included. Basic details including age, gender, disease duration, detailed history, and clinical examination were noted. Autoimmune profiling included rheumatoid factor, antinuclear antibodies, and anti-Scl-70 antibodies. Pulmonary function test, chest X-ray (CXR), and high-resolution computed tomography of the chest (HRCT) in all patients were recorded. Data presented either as frequencies and percentages or as means ± standard deviation. Results: The male: female ratio was 1:9 with a mean age of 37.5 ± 9.6 years and duration of illness 6 ± 4 years. diffuse cutaneous SSc was seen in 62.5% of the patients. 77.5% of the participants had bilateral crepitation and 57.5% had loud P2. Presenting complaints included gastrointestinal reflux in 72.5%, digitalis ulcerations in 40%, and synovitis/arthritis of all patients. Other comorbidities included congestive heart failure in 12.5%, PH in 15%, and renal impairments in 7.5% of all patients. Anti-Scl-70 antibody was the most common in all patients (45%), followed by anti-centromere Ab (25%), anti-U3 RNP (10%), and anti-U1 RNP (5%). 72.5% of the participants had reticulonodular shadows on CXR. HRCT showed honeycombing as the predominant finding (37.5%). Echocardiograms showed that 15% of all patients have signs of PH. Duration of disease, dyspnea, cough, bilateral crepitations, and CXR were found to be significantly associated with extensive ILD (P < 0.05). Conclusion: ILD is a serious complication of SSc, it is more common among patients with dcSSc. Chest HRCT is very sensitive to detect ILD. A significant association was found in Libyan patients between the severity of ILD and the duration of disease, dyspnea, cough, bilateral crepts, and CXR.
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Impact of treatment and the contribution of persistent posttreatment bacterial vaginosis infection on pregnancy outcome among asymptomatic women: A cohort study p. 33
Babatunde D Ogunniran, Abiodun S Adeniran, Rakiya Saidu, Ajibola A Akanbi II, Kikelomo T Adesina, Munirdeen A Ijaiya
DOI:10.4103/liuj.liuj_49_20  
Objective: The objective of this study was to evaluate the effect of antibiotic treatment and posttreatment persistent bacterial vaginosis (BV) infection on pregnancy outcome among asymptomatic women. Materials and Methods: A prospective cohort study was conducted among consenting, asymptomatic pregnant women without background medical disorders. All participants were recruited in the second trimester and had BV testing using Nugent score. BV-positive women were treated with a 7-day course of metronidazole with a repeat posttreatment laboratory testing after 4 weeks. The primary outcome was pregnancy outcome of BV-positive versus negative women; the secondary outcomes were posttreatment laboratory BV test result and pregnancy outcome among women with resolution versus persistent infection. Data analysis was performed using SPSS version 21.0 and P < 0.05 was significant. Results: The prevalence of BV in pregnancy was 24.1%; vulva itching and vaginal douching were more common among BV-positive women (P = 0.011 and P = 0.001), respectively. Adverse pregnancy outcomes such as premature rupture of membranes (PROM) (odds ratio [OR]: 8.185, 95% confidence interval [CI]: 3.196–20.962; P = 0.005), preterm delivery (OR: 24.517, 95% CI: 6.985–86.049; P = 0.001), and birth weight <2500 g (OR: 6.460, 95% CI: 2.893–14.429; P = 0.005) were more common among BV-positive women. Posttreatment persistent BV infection was 25.0% with significantly higher PROM (OR: 18.21, 95% CI: 4.654–71.317; P = 0.001), preterm delivery (OR: 14.571, 95% CI: 4.138–51.308; P = 0.001), birth weight <2500 g (OR: 14.57, 95% CI: 4.138–51.308; P = 0.001), and low 1st min Apgar scores (OR: 7.333, 95% CI: 1.223–43.960; P = 0.049). Conclusion: Symptom-based approach to BV in pregnancy excludes many asymptomatic women; we hereby recommend routine screening. Also, women with BV in pregnancy should undergo repeat testing posttreatment while those with persistent infection will benefit from repeat treatment pending further evidence to formulate a widely acceptable treatment guideline.
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Placental changes and perinatal outcomes among women with preeclampsia/eclampsia and normotensive women: A comparative study p. 41
Adebunmi Oyeladun Olarinoye, Olaleke Oluwasegun Folaranmi, Babakayode Abel Olagbaye, John Kola Olarinoye, Kike Temilola Adesina, Abiodun S Adeniran
DOI:10.4103/liuj.liuj_57_21  
Objective: The study objective was to evaluate placental changes and the perinatal outcomes among women with preeclampsia/eclampsia and compare to normotensive pregnant women. Materials and Methods: This was a comparative (prospective) study, participants were 146 pregnant women; 73 preeclamptic/eclamptic (study group) and 73 normotensive (control group) at 28–40-week gestation selected by purposive sampling. The primary outcome measure was the placenta characteristics, while the secondary outcome was the perinatal outcomes. Statistical analysis was done using SPSS version 23.0, and statistical significance was set at P ≤ 0.05. Results: The mean placental weight for study group was significantly lower than controls (556.82 g ± 169.72 vs. 649.93 g ± 116.38; P ≤ 0.001); 12 (16%) placentae in the study group had gross placental infarction compared to none (0%) among controls. Study group placentae showed 11 types of microscopic placental changes compared to four among controls. Decidual vasculopathy (P = 0.049), incomplete vascular modeling (P = 0.019), accelerated villi maturity (P = 0.049), acute chorioamnionitis (P = 0.048), and microcalcifications (P = 0.040) were significantly associated with low APGAR scores in the study group. The 1st and 5th min APGAR scores were lower in the study group (P ≤ 0.001, 49.3% vs. 8.2%) and (P = 0.002, 11% vs. 0%), respectively, while all the eight perinatal mortality recorded were in the study group. Conclusion: Preeclampsia/eclampsia is associated with abnormal gross and microscopic placental changes which predisposes to increased adverse perinatal outcome. Antenatal surveillance for preeclampsia/eclampsia should prioritize Doppler studies to characterize the placenta and appropriately plan the delivery.
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CASE REPORT Top

The impact of COVID-19 pandemic on education: Case report p. 47
Adel Ibrahim Altawaty, Sara Abdalla Glessa, Mohammed Saad Ambarek
DOI:10.4103/liuj.liuj_68_21  
In this article, we report on the transformation from face-to-face learning to online virtual learning in the Libyan International Medical University (LIMU). Due to the widespread of COVID-19 worldwide, the Libyan government has enforced a full lockdown on higher education institutions without providing any solutions. This lockdown involved all public and private schools, and universities. Consequently, LIMU transformed its education strategy from face-to-face learning to virtual learning. The learning management system “Moodle” was already used in LIMU since its establishment which made the transformation to online learning much easier to students. Virtual learning is represented by audio and video recording of lectures, and laboratory lessons, live interviews, and interactive sessions for seminars, PBL, and lectures. Students' assessments, both formative and summative assessments were applied using Moodle quizzes and Safe Exam Browser. During the whole process of change, we faced many challenges and limitations. In conclusion, because of the COVID-19 pandemic, we had the opportunity to experience online education which is the best platform to keep safe and to continue their learning.
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SHORT COMMUNICATION Top

Portfolios in medical education: A tool for learning and assessment of medical students p. 51
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/liuj.liuj_46_20  
The period of medical training is a long one and it is quite crucial for a medical student to document their learning, substantiate the same with evidence, and record personal reflections to make it a long-term learning. Portfolios have been identified as a tool for learning as it envisages the value of student-centered learning, gives importance to what a learner can accomplish, and can be used as a tool for both learning and assessment. As the primary objective of the portfolio is a reflection on learning, it plays a significant role to ensure professional growth and development. In conclusion, advocating the use of a portfolio among medical students is the foundation stone for lifelong learning and ensures continuous professional development. It is the need of the hour that all the medical colleges should implement the maintenance of the portfolio within their settings based on a framework that clearly defines the purpose for the same and its periodical assessment.
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