Libyan Journal of Medicine 

About: Libyan Journal of Medicine is an academic journal published by Taylor & Francis. The journal publishes majorly in the area(s): Medicine & Population. It has an ISSN identifier of 1819-6357. It is also open access. Over the lifetime, 557 publications have been published receiving 6464 citations. The journal is also known as: LJM.

Burnout among physicians.

Abstract: Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to cognitive-behavioral and patientcentered therapy have been found to be of utmost significance when it comes to preventing and treating burnout. However, evidence is insufficient to support that stress management programs can help reducing jobrelated stress beyond the intervention period, and similarly mindfulness-based stress reduction interventions efficiently reduce psychological distress and negative vibes, and encourage empathy while significantly enhancing physicians’ quality of life. On the other hand, a few small studies have suggested that Balint sessions can have a promising positive effect in preventing burnout; moreover exercises can reduce anxiety levels and exhaustion symptoms while improving the mental and physical well-being of healthcare workers. Occupational interventions in the work settings can also improve the emotional and work-induced exhaustion. Combining both individual and organizational interventions can have a good impact in reducing burnout scores among physicians; therefore, multidisciplinary actions that include changes in the work environmental factors along with stress management programs that teach people how to cope better with stressful events showed promising solutions to manage burnout. However, until now there have been no rigorous studies to prove this. More interventional research targeting medical students, residents, and practicing physicians are needed in order to improve psychological well-being, professional careers, as well as the quality of care provided to patients. Keywords: burnout; health care professionals; stress management; mindfulness-based stress reduction programs; physicians well-being (Published: 17 February 2014) Citation: Libyan J Med 2014, 9 : 23556 - http://dx.doi.org/10.3402/ljm.v9.23556

Lemon grass (Cymbopogon citratus) essential oil as a potent anti-inflammatory and antifungal drugs

Abstract: Background : Volatile oils obtained from lemon grass [ Cymbopogon citratus (DC.) Stapf, Poaceae family] are used in traditional medicine as remedies for the treatment of various diseases. Aims : In the present study, lemon grass essential oil (LGEO) was evaluated for its in vivo topical and oral anti-inflammatory effects, and for its in vitro antifungal activity using both liquid and vapor phases. Methods : The chemical profile of LGEO as determined by gas chromatography–mass spectrometry analysis revealed two major components: geranial (42.2%), and neral (31.5%). The antifungal activity of LGEO was evaluated against several pathogenic yeasts and filamentous fungi using disc diffusion and vapor diffusion methods. Results : LGEO exhibited promising antifungal effect against Candida albicans , C. tropicalis , and Aspergillus niger , with different inhibition zone diameters (IZDs) (35–90 mm). IZD increased with increasing oil volume. Significantly, higher anti- Candida activity was observed in the vapor phase. For the evaluation of the anti-inflammatory effect, LGEO (10 mg/kg, administered orally) significantly reduced carrageenan-induced paw edema with a similar effect to that observed for oral diclofenac (50 mg/kg), which was used as the positive control. Oral administration of LGEO showed dose-dependent anti-inflammatory activity. In addition, topical application of LGEO in vivo resulted in a potent anti-inflammatory effect, as demonstrated by using the mouse model of croton oil-induced ear edema. To our knowledge, this is the first such report to be published. The topical application of LGEO at doses of 5 and 10 µL/ear significantly reduced acute ear edema induced by croton oil in 62.5 and 75% of the mice, respectively. In addition, histological analysis clearly confirmed that LGEO inhibits the skin inflammatory response in animal models. Conclusion : Results of the present study indicate that LGEO has a noteworthy potential for the development of drugs for the treatment of fungal infections and skin inflammation that should be explored in future studies. Keywords: lemon grass; essential oil; antifungal activity; anti-inflammatory effect; citral; aromatherapy (Published: 19 September 2014) Citation: Libyan J Med 2014, 9 : 25431 - http://dx.doi.org/10.3402/ljm.v9.25431

Efflux pump inhibitors (EPIs) as new antimicrobial agents against Pseudomonas aeruginosa

Abstract: Pseudomonas aeruginosa is an opportunistic human pathogen and one of the leading causes of nosocomial infections worldwide. The difficulty in treatment of pseudomonas infections arises from being multidrug resistant (MDR) and exhibits resistance to most antimicrobial agents due to the expression of different mechanisms overcoming their effects. Of these resistance mechanisms, the active efflux pumps in Pseudomonas aeruginosa that belong to the resistance nodulation division (RND) plays a very important role in extruding the antibiotics outside the bacterial cells providing a protective means against their antibacterial activity. Beside its role against the antimicrobial agents, these pumps can extrude biocides, detergents, and other metabolic inhibitors. It is clear that efflux pumps can be targets for new antimicrobial agents. Peptidomimetic compounds such as phenylalanine arginyl β-naphthylamide (PAβN) have been introduced as efflux pump inhibitors (EPIs); their mechanism of action is through competitive inhibition with antibiotics on the efflux pump resulting in increased intracellular concentration of antibiotic, hence, restoring its antibacterial activity. The advantage of EPIs is the difficulty to develop bacterial resistance against them, but the disadvantage is their toxic property hindering their clinical application. The structure activity relationship of these compounds showed other derivatives from PAβN that are higher in their activity with higher solubility in biological fluids and decreased toxicity level. This raises further questions on how can we compact Pseudomonas infections. Of particular importance, the recent resurgence in the use of older antibiotics such as polymyxins and probably applying stricter control measures in order to prevent their spread in clinical sittings.

Anatomic Variation of Sphenoid Sinus and Related Structures in Libyan Population: CT Scan Study

Abstract: Background: Sphenoid sinus is the most inaccessible paranasal sinus, enclosed within the sphenoid bone and intimately related to numerous vital neural and vascular structures. Anatomic variation of the sphenoid sinus is well documented and may complicate surgery in such a place. Objective: To outline the surgically risky anatomic variants of the sphenoid sinus as well as the variable relationships between the sinus and related neurovascular structures, for the safe removal of intrasphenoid and pituitary lesions. Materials and Methods: We undertook a prospective review of 300 paranasal sinus CT scans of Libyan patients; coronal CT scans were obtained by special parameter techniques. We assessed pneumatization of pterygoid process (PP), anterior clinoid process (ACP), and greater wing of sphenoid (GWS); we also examined protrusion and dehiscence of internal carotid artery (ICA), optic nerve (ON), maxillary nerve (MN), and vidian nerve (VN) into the sphenoid sinus cavity. Results: Pneumatization of PP, ACP, and GWS were seen in 87 (29%), 46 (15.3%), and 60 patients (20%), respectively. Protrusion of ICA, ON, MN, and VN were noticed in 123 (41%), 107 (35.6%), 73 (24.3%), and 81 patients (27%), respectively; dehiscence of these structures was encountered in 90 (30%), 92 (30.6%), 39 (13%), and 111 patients (37%), respectively. Statistically, there was a highly significant association between ACP pneumatization and ICA protrusion, ACP pneumatization and ON protrusion, PP pneumatization and VN protrusion; and GWS pneumatization and MN protrusion (p-value < 0.001). Conclusion: The sphenoid sinus is highly variable; this variability necessitates a comprehensive understanding of the regional sphenoid sinus anatomy by a detailed CT scan sinus examination before surgery in and around the sinus. This study indicates the possibility of a racial anatomical variation of the sphenoid sinus in the Libyan population. Key words: Sphenoid sinus, variation, internal carotid artery, optic nerve, maxillary nerve, vidian nerve, CT scan, Libyan.

Prevalence and predictors of irritable bowel syndrome among medical students and interns in King Abdulaziz University, Jeddah

Abstract: Background: Irritable bowel syndrome (IBS) is a frequent, costly, and potentially disabling gastrointestinal disorder. Medical education is among the most challenging and the most stressful education, and this may predispose to high rates of IBS. Objective: To determine the prevalence and predictors of IBS among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia. Methods: A cross-sectional study was conducted among 597 medical students and interns selected by multistage stratified random sample method in 2012. A confidential, anonymous, and self-administered questionnaire was used to collect personal and sociodemographic data, level of emotional stress, and food hypersensitivity during the past 6 months. Rome III Criteria and the Standardized Hospital Anxiety and Depression Scale were also used. Results: The prevalence of IBS was 31.8%. Multiple logistic regression analysis revealed that the first predictor of IBS was female gender (aOR=2.89; 95.0% CI: 1.65-5.05). The second predictor was presence of morbid anxiety (aOR=2.44; 95.0% CI: 1.30-4.55). Living in a school dormitory, emotional stress during 6 months preceding the study, and the academic year were the next predictors. Conclusions: High prevalence of IBS prevailed among medical students and interns. Female gender, morbid anxiety, living in school dormitory, emotional stress, and higher educational level (grade) were the predictors of IBS. Screening of medical students for IBS, psychological problems, and reducing stress by stress management are recommended. Keywords: epidemiology; irritable bowel syndrome; medical students; Jeddah (Published: 19 September 2013) Citation: Libyan Journal of Medicine 2013, 8 : 21287 - http://dx.doi.org/10.3402/ljm.v8i0.21287