Libyan International Medical University Journal

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Objective: Anterior crossbite presents when one or more of the upper incisors occlude lingual to lower incisors. Several techniques were used to correct anterior crossbite. The aim of this article was to present the treatment of anterior crossbite under skeletal Class I relationship using multilooped archwire. Methods: A 24-year-old female has a complaint of anterior crossbite. She has concave profile, all her teeth present except the maxillary canines, 4 mm reverse overjet, 4 mm crowding in the lower anterior and 25% overbite. The treatment was started in the lower arch by the extraction of the lower first premolars. Different arch sequences of nickel–titanium alloys, followed by different sequences of stainless steel archwires were used. Results: The correction of crossbite was achieved successfully within 18 months. Normal overjet and overbite and orthognathic profile were accomplished. Conclusion: The treatment of anterior crossbite was achieved using retraction multilooping arch to achieve normal overjet and overbite.

Background: Access to combination antiretroviral therapy (ART) enables HIV-positive women to live longer in good health. Some of these women are sexually active having unintended pregnancies and unsafe abortions because of not using contraceptives. Objective: This study assessed pattern of contraceptive use by HIV-positive women of reproductive age group attending an HIV treatment center at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Materials and Methods: A descriptive cross-sectional study of 400 HIV-positive women that completed an interviewer-administered semi-structured questionnaire on awareness and use of contraceptives. Data collected were analyzed with SPSS version 17. Results: Majority, 217 (54.3%), had been pregnant since enrollment with 120 (55.3%) having an induced abortion. Majority, 378 (94.5%), were aware of contraception with health workers as the source of awareness being 204 (54%). Although 313 (82.8%) desire to use a contraceptive, 281 (74.3%) currently used a contraceptive with male condom, 130 (34.4%), being the most common type used. Selected factors significantly associated with contraceptive use included age 35 years and above (odds ratio [OR] =2.58, 95% confidence interval [CI] = 1.18–5.63, P = 0.018), higher education (OR = 4.48, 95% CI = 2.80–7.16, P = 0.0001), being unmarried (OR = 4.34, 95% CI = 2.74–6.88, P = 0.0001), skilled worker (OR = 4.64, 95% CI = 2.76–7.81, P = 0.0001), higher income (OR = 2.15, 95% CI = 1.20–3.82, P = 0.01), and increasing duration on highly active ART 6–12 months (OR = 8.88, 95% CI = 4.50–17.50, P = 0.0001) and >12 months (OR = 4.37, 95% CI = 2.27–8.43, P = 0.0001). Conclusions: Some sexually active HIV-positive women were not using contraceptives. It is necessary to increase contraceptive awareness and use among this vulnerable population.

Background: In pediatric inguinal hernia, the most feared complication is incarceration, which can lead to catastrophic consequences if not resolved expeditiously. Aims: This study assessed the usefulness of manual reduction of complicated inguinal hernia in children. Settings and Design: This study was designed to study the age at presentation, gestation age at birth, duration of symptoms, success rate of manual reduction of incarcerated inguinal hernia, subsequent treatment, operative findings, and outcome of strangulated cases in pediatric patients. Materials and Methods: This is a retrospective study involving 56 children under 15 years of age with a diagnosis of complicated inguinal hernia managed between January 2009 and December 2018 at a tertiary care hospital in Nigeria. Demographic characteristics, clinical presentations, management, and outcome were retrieved. Data were analyzed using SPSS software version 22 (IBM Corp., NY, USA). The results were presented as frequencies and percentages. Categorical variables were analyzed using Chi-square test. P < 0.05 was deemed statistically significant. Results: The age of patients ranged between 8 days and 14 years, with a median of 2 months; 79% were infants. Males outnumbered females by a ratio of 27:1, and the rate of incarceration was 5.0%. Majority (89.3%) had no previous hospital visits. Those who had successful manual reduction was 80%. Time of presentation was a statistically significant factor for successful reduction, P < 0.05. One patient experienced en masse reduction, and there was no mortality. Conclusion: Majority of those with incarcerated inguinal hernias were infants, and manual reduction was associated with early presentation.

Problem-based learning (PBL) is a few decades-old innovative educational strategy that is spreading throughout the academic world. The Libyan International Medical University decided to adopt this strategy and to change from its traditional system shortly after its establishment in the year 2007. This case study aimed to outline the reasons for considering the change, the obstacles, and the strategies adopted throughout the university to effect the change at the student, faculty, curriculum, physical environment, and organization levels and also to compare this experience with that of other universities. significant implementation of PBL was accomplished using a combination of three types of change strategies: rational, normative re-educative, and coercive. It was also shown that this experience of implementation of PBL is quite similar to that of other universities and colleges. It was concluded from this case study that a combination of change strategies was productive in bringing up the change, and that the strategies adopted as well as the obstacles faced are similar to those reported by other universities.

The Corona Virus Disease-2019 (COVID-19) pandemic has influenced the lives of millions of people across the world and forced all the public health authorities to divert their attention towards the disease. The refugees and migrants have been recognized as vulnerable population groups and it is a must that in general, we should try to meet the needs of these population groups in this ongoing pandemic. Considering the practical concerns pertaining to the difficulty in accessing health care or residing in overcrowded settings or poor water supply, it makes them extremely vulnerable to COVID-19 infection, as all these factors play an important role in enhancing the transmission of the disease. The need of the hour is to prevent the possibility of stigma and discrimination and ensure that reliable and timely information is passed to them through trustworthy resources. Further, all steps should be taken to inform them about the need to maintain social distancing, use of personal protective equipment and strict adherence to the infection prevention and control recommendations. In conclusion, in the battle against the COVID-19 pandemic, the refugees and migrants deserve equal priority and attention like that of the general population. However, considering their vulnerability to acquire the infection due to varying environmental and social attributes, it becomes crucial to facilitate early detection and isolation of the cases and thereby interrupt the chain of transmission and thus reduce the overall caseload.

Online since 20^th December 2017.