Medical ethics in Libya: where to start?

When it was decided that I will write the editorial for the second issue of the Libyan Journal of Medicine, I was not sure where to start. There are many topics that are related to global health issues and many are specifically related to the health system in Libya. For this issue, I decided to start some discussion on medical ethics as it relates to the Libyan medical culture

The National Day for the Libyan Physician

The health sector is a vital component of the growth and maintenance of every economy. When you examine any country’s annual budget, you immediately recognize that a large proportion goes to the healthcare sector. You may also see it is a part of expenditure and not of productivity. In other words, healthcare is a liability item when it comes to the budget. Libya is no exception.The goal of the health planners is to allocate the healthcare budget in ways that will ultimately result in a healthier society. In Libya, unfortunately, it is not clear how much of the budget goes to the health profession and health care delivery, and how much of it is spent on administrative issues. When you focus on the health sector you discover that it is really a significant mover of the productivity line. It is very simple. Healthy citizens are more likely to go to school and be educated. They are also more likely to have steady employment and be productive members of the society. That is not the subject of these comments. No one can deny that the Libyan physicians are on the frontline when it comes to criticism of the health services in Libya. I agree that they should be on the frontline. After all, medical schools in Libya started many years before the creation of other colleges for allied health professionals. They have a major share of responsibility in keeping our citizens healthy. It is also their responsibility to treat those who become sick. This requires a health system with a solid, transparent, ethical, and well organized structure. This is not the subject of my comments either. The purpose of my comments today is to draw attention to the Libyan physicians and recognize them once a year. I feel that they are busy with their work and the basic ingredients of life in a developing country. I also believe that they are relatively forgotten by society. What I would like to propose is the creation of a national observation for the Libyan physician. I think it is time to celebrate a Libyan Physician Day (Youm attabeeb alleebi) during which the Libyan physician is recognized in all health institutions at the level of the ministry, press, television, radio, as well as hospitals and rural health care units. During this day, we thank the Libyan physician for his/her hard work under diverse conditions and circumstances (1). During this day, we remind the physician of his/her duty toward humanity in general and Libyan citizens in particular. The physicians need to know that they have a moral and ethical (2) duty toward the Libyan citizen from birth to death. This duty extends to the poor and to the wealthy and it does not discriminate against colour, race, or religion of the citizen. This duty is purely humane and has no allegiance to political beliefs. We also remind the Libyan physician to extend his/her hands to colleagues in basic science, in different sectors of medical education, and the allied medical personnel. We all know that without nurses, pharmacists, physiotherapists, respiratory therapist, laboratory technicians, physicists and radiology technicians we can not perform our jobs. On this day, we inform the Libyan physicians that we love them and respect their field. The society and government should be united in providing them with decent living standards. The Libyan physicians are human and have needs and responsibilities toward their families and deserve a decent life. This acknowledgment by the society and the government gives them a moral boost. Hopefully, it would provide an incentive to work harder and to be creative to minimize the flux of the Libyan patients to the neighbouring countries for the treatment of simple ailments. I truly believe that the creation of a national day for the Libyan physician will be fruitful within few years of its initiation. It will certainly shed the light on this group of the Libyan society. It will remind physicians to give more consideration to interactions with members of the Libyan society. We hope the idea will find its way to the legislators to adopt and designate a day to celebrate the Libyan Physician.This day can be any time; however, I would propose selecting a day in the summer to enable the participation of most Libyan physicians while children are out of school. Such participation could be in the form of public health screenings and information about major diseases such as diabetes, high blood pressure, strokes and breast cancer. Informational discussions of socio-medical problems such as substance abuse and drug addiction could also be included. It is my hope that my colleagues will discuss this issue, voice their opinions, and provide suggestions of other activities to commemorate our physicians on this day

Analysis of Tooth Extraction Causes and Patterns

PURPOSE: The purpose of this study was to investigate the causes and patterns of extraction of permanent teeth in the targeted population. METHODS: The study was conducted for a period of 11 months. An especially designed form was used to record the causes for extraction of a permanent tooth. Further, it was analyzed for age, gender, education, occupation, smoking, tooth position, endodontic treatment, chewing, esthetics, needs replacement, type of existing prosthesis, and causes for extraction. The various causes which were considered to determine association with the tooth extraction were dental caries, periodontal problems, trauma, orthodontics, prosthodontic failures, endodontic failures, and others. RESULTS: The percentage of extractions was almost the same in males and females aged. Maximum extractions were noticed in 36–45 years of age group (32.5%). The presence of caries was observed to be the main reason for extraction (68.1%), followed by periodontal problems (17.6%) and orthodontic problems (4.8%). The most frequently extracted posterior teeth were first mandibular molar (22.2%), followed by the third maxillary molar (15.2%). CONCLUSION: Dental caries was found to be the most common reason for the extraction of teeth. Molar teeth were found to be the most frequently extracted, with an increased number of extracted first premolars as a result of orthodontic treatment. Maxillary teeth are extracted more than mandibular, mainly due to caries and periodontal problems

Improvements in Multicarrier Modulation Systems using a Wavelet OFDM Scheme

yesThis paper investigates the performance of wavelet OFDM signals over a wireless communications link. The scheme is shown to be generally similar to Fourier based OFDM, but with some additional features, and improved characteristics. The sensitivity of both schemes to the nonlinear amplification in the transmitter is compared by monitoring the time domain output data and the adjacent channel power ratio (ACPR) performance

Assessing variability in the wideband mobile radio channel.

yesAn assessment of the performance of OFDM transmissions over the wideband mobile radio channel is reported. The simulation in MATLAB /Simulink is based on the CODIT channel model. The results show that BER deteriorates significantly as the mobile velocities increase from 0 to 30 m/s. Significant variability in the BER for a given channel type is quantified. For a given instance of the channel the standard deviation of the estimated BER is 20%, but when averaged over many separate instances of the same channel type, a standard deviation of 47% is found

Racial differences in renal allograft survival: The role of systemic hypertension

Racial differences in renal allograft survival: The role of systemic hypertension. The rate of decline in the number of functioning renal allografts beyond the first year after transplantation has changed little in the last 25 years, and during long-term follow-up most allografts are lost due to chronic transplant rejection or patient death. The recipient race correlates with allograft survival, and African American recipients have a lower allograft survival than Caucasians. The goal of the present study was to identify clinical variables present during the first six months after transplantation that predict the loss of renal allografts beyond six months after transplantation, and in particular to determine the role of systemic hypertension on renal allograft survival in black and white recipients. This study includes 547 recipients of first cadaveric renal allografts performed at The Ohio State University. All patients were treated with a uniform immunosuppressive protocol and had a follow-up of at least three years. By multivariate analysis the following variables correlate with poor allograft survival: an elevated serum creatinine concentration measured six months after transplantation (SCr6mo) (P < 0.0001); black race (P < 0.0001); increasing numbers of acute rejection episodes (ATR) (P = 0.002); and young recipients (P = 0.026). Allograft survival is significantly worse in black (mean allograft half-life of 7.7 ± 1.3 years) than in white recipients (24 ± 3 years) (P < 0.0001). Black recipients also have a significantly higher six month average mean arterial blood pressure (MAP) (105 ± 8 mm Hg) than white recipients (102 ± 7 mm Hg) (P = 0.002). However, the prevalence of hypertension is not significantly different in black (33%) than in white recipients (26%). Furthermore, increasing MAP levels correlate with a shorter allograft half-life in black recipients (P = 0.0002), but not in white recipients (P = 0.84). Allograft survival was eight times shorter in hypertensive black (3.1 ± 0.7 years) than in hypertensive white recipients (24.6 ± 7 years). In contrast, allograft survival was not statistically different between normotensive black and white patients. In conclusion, the presence of poorly controlled systemic hypertension, early after renal transplantation, correlates with poor allograft survival in black recipients. Thus, systemic hypertension may explain, in part, differences in renal allograft survival between black and white patients

Blockchain security for 5G network using Internet of Things devices

Network of vehicles using Internet of Things (IoT) frameworks have efficient characteristics of modern intelligent transportation system with a few challenges in vehicular ad-hoc networks (VANETs). However, its security framework is required to manage trust management by preserving user privacy. Wireless mobile communication (5G) system is regarded as an outstanding technology that provide ultra-reliable with limited latency wireless communication services. By extension, integrating Software Defined Network (SDN) with 5G-VANET enhances global information gathering and network control. Therefore, real-time IoT application for monitoring transport services is efficiently supported. These ensures vehicular security on this framework. This paper provides a technical solution to a self-confidential framework for a smart transport system. This process exploiting IoT for vehicle communication by incorporating SDN and 5G technology. Due to some features of blockchain, this framework has been implemented to provide various alternative support for vehicular smart services. This involves real-time access to cloud to stream video information and protection management to vehicular network. The implemented framework presents a promising technique and reliable vehicular IoT environment while ensuring user privacy. Results of simulation presents that vehicular nodes/messages (malicious) and overhead is detected and the impact on network performance are satisfactory when deployed in large-scale network scenarios

Anti-cancer effects and mechanism of actions of aspirin analogues in the treatment of glioma cancer

INTRODUCTION: In the past 25 years only modest advancements in glioma treatment have been made, with patient prognosis and median survival time following diagnosis only increasing from 3 to 7 months. A substantial body of clinical and preclinical evidence has suggested a role for aspirin in the treatment of cancer with multiple mechanisms of action proposed including COX 2 inhibition, down regulation of EGFR expression, and NF-κB signaling affecting Bcl-2 expression. However, with serious side effects such as stroke and gastrointestinal bleeding, aspirin analogues with improved potency and side effect profiles are being developed. METHOD: Effects on cell viability following 24 hr incubation of four aspirin derivatives (PN508, 517, 526 and 529) were compared to cisplatin, aspirin and di-aspirin in four glioma cell lines (U87 MG, SVG P12, GOS – 3, and 1321N1), using the PrestoBlue assay, establishing IC50 and examining the time course of drug effects. RESULTS: All compounds were found to decrease cell viability in a concentration and time dependant manner. Significantly, the analogue PN517 (IC50 2mM) showed approximately a twofold increase in potency when compared to aspirin (3.7mM) and cisplatin (4.3mM) in U87 cells, with similar increased potency in SVG P12 cells. Other analogues demonstrated similar potency to aspirin and cisplatin. CONCLUSION: These results support the further development and characterization of novel NSAID derivatives for the treatment of glioma