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Article ; Online: Acute pancreatitis associated with severe acute respiratory syndrome coronavirus-2 infection

Abdullah S. Eldaly / Ayman R. Fath / Sarah M. Mashaly / Muhammed Elhadi

Journal of Medical Case Reports, Vol 15, Iss 1, Pp 1-

a case report and review of the literature

2021 Volume 12

Abstract: Abstract Introduction We report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation. Case ... ...

Abstract	Abstract Introduction We report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation. Case presentation An otherwise healthy 44-year-old white male from Egypt presented to the hospital with severe epigastric pain and over ten attacks of nonprojectile vomiting (first, gastric content, then bilious). Acute pancreatitis was suspected and confirmed by serum amylase, serum lipase, and computed tomography scan that showed mild diffuse enlargement of the pancreas. The patient did not have any risk factor for acute pancreatitis, and extensive investigations did not reveal a clear etiology. Given a potential occupational exposure, a nasopharyngeal swab for polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was done, which was positive despite the absence of the typical symptoms of severe acute respiratory syndrome coronavirus 2 such as fever and respiratory symptoms. The patient was managed conservatively. For pancreatitis, he was kept nil per os for 2 days and received intravenous lactated Ringer’s (10 ml per kg per hour), nalbuphine, alpha chymotrypsin, omeprazole, and cyclizine lactate. For severe acute respiratory syndrome coronavirus 2, he received a 5-day course of intravenous azithromycin (500 mg per day). He improved quickly and was discharged by the fifth day. We know that abdominal pain is not a rare symptom of severe acute respiratory syndrome coronavirus 2, and we also know that elevated levels of serum amylase and lipase were reported in severe acute respiratory syndrome coronavirus-2 patients, especially those with severe symptoms. However, the association between severe acute respiratory syndrome coronavirus-2 infection and idiopathic acute pancreatitis is rare and has been reported only a few times. Conclusion We believe further studies should be conducted to determine the extent of pancreatic involvement in severe acute ...
Keywords	Acute pancreatitis ; Pancreas ; SARS-CoV-2 ; COVID-19 ; Case report ; Medicine ; R
Subject code	610 ; 572
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Informed self-assessment versus preceptor evaluation

Muhammed Elhadi / Hazem Ahmed / Ala Khaled / Wejdan K. Almahmoudi / Samah S. Atllah / Ahmed Elhadi / Hamida Esahli

BMC Medical Education, Vol 20, Iss 1, Pp 1-

a comparative study of pediatric procedural skills acquisition of fifth year medical students

2020 Volume 8

Abstract: Abstract Background Simulation training is widely used in medical education as students rarely perform clinical procedures, and confidence can influence practitioners’ ability to perform procedures. Thus, this study assessed students’ perceptions and ... ...

Abstract	Abstract Background Simulation training is widely used in medical education as students rarely perform clinical procedures, and confidence can influence practitioners’ ability to perform procedures. Thus, this study assessed students’ perceptions and experiences of a pediatric skills program and compared their informed self-assessment with their preceptor-evaluated performance competency for several pediatric clinical procedures. Methods A total of 65 final-year medical students attended a weeklong pediatric skills training course by the University of Tripoli that used a manikin and various clinical scenarios to simulate real-life cases. Participants completed questionnaires self-assessing their performance skills, while examiners evaluated each students’ competency on five procedural skills (lumbar puncture, nasogastric tube insertion, umbilical vein catheterization, intraosseous access, and suprapubic aspiration) using an objective structured clinical examination (OSCE) model. Differences between agreement levels in question responses were evaluated through a nonparametric chi-square test for a goodness of test fit, and the relationship between confidence levels and the OSCE scores for each procedure was assessed using Spearman’s rank-order correlation. Results All participants completed the informed self-assessment questionnaire and OSCE stations. The frequency differences in agreement levels in students’ questionnaire responses were statistically significant. No significant differences were found between students’ self-assessment and preceptors’ evaluation scores. For each procedure’s passing score rate, umbilical vein catheterization had the highest passing rate (78.5%) and nasogastric tube placement the lowest (56.9%). The mean performance scores were above passing for all procedures. The Wilcoxon signed-rank test revealed no significant differences between participants’ self-assessment and their preceptor-evaluated competency; students correctly perceived and assessed their ability to perform each ...
Keywords	Education ; Medical student education ; Self-assessment ; Simulation ; Pediatrics ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	370
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Consent is a confounding factor in a prospective observational study of critically ill elderly patients.

Hans Flaatten / Bertrand Guidet / Christian Jung / Ariane Boumendil / Susannah Leaver / Wojciech Szczeklik / Antonio Artigas / Finn Andersen / Rui Moreno / Sten Walther / Sandra Oeyen / Joerg C Schefold / Brian Marsh / Michael Joannidis / Muhammed Elhadi / Yuriy Nalapko / Jesper Fjølner / Dylan W de Lange

PLoS ONE, Vol 17, Iss 10, p e

2022 Volume 0276386

Abstract: During analysis of a prospective multinational observation study of critically ill patients ≥80 years of age, the VIP2 study, we also studied the effects of differences in country consent for study inclusion. This is a post hoc analysis where the ICUs ... ...

Abstract	During analysis of a prospective multinational observation study of critically ill patients ≥80 years of age, the VIP2 study, we also studied the effects of differences in country consent for study inclusion. This is a post hoc analysis where the ICUs were analyzed according to requirement for study consent. Group A: ICUs in countries with no requirement for consent at admission but with deferred consent in survivors. Group B: ICUs where some form of active consent at admission was necessary either from the patient or surrogates. Patients' characteristics, the severity of disease and outcome variables were compared. Totally 3098 patients were included from 21 countries. The median age was 84 years (IQR 81-87). England was not included because of changing criteria for consent during the study period. Group A (7 countries, 1200 patients), and group B (15 countries, 1898 patients) were comparable with age and gender distribution. Cognition was better preserved prior to admission in group B. Group A suffered from more organ dysfunction at admission compared to group B with Sequential Organ Failure Assessment score median 8 and 6 respectively. ICU survival was lower in group A, 66.2% compared to 78.4% in group B (p<0.001). We hence found profound effects on outcomes according to differences in obtaining consent for this study. It seems that the most severely ill elderly patients were less often recruited to the study in group B. Hence the outcome measured as survival was higher in this group. We therefore conclude that consent likely is an important confounding factor for outcome evaluation in international studies focusing on old patients.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Psychological Impact of the Civil War and COVID-19 on Libyan Medical Students

Muhammed Elhadi / Anis Buzreg / Ahmad Bouhuwaish / Ala Khaled / Abdulmueti Alhadi / Ahmed Msherghi / Ahmed Alsoufi / Hind Alameen / Marwa Biala / Alsafa Elgherwi / Fatimah Elkhafeefi / Amna Elmabrouk / Abdulmuez Abdulmalik / Sarah Alhaddad / Moutaz Elgzairi / Ahmed Khaled

Frontiers in Psychology, Vol

A Cross-Sectional Study

2020 Volume 11

Abstract: ObjectiveWe aim to determine the psychological status of medical students during the COVID-19 outbreak and civil war in Libya.MethodsA cross-sectional study was conducted among medical students from 15 medical schools between April 20 and May 1, 2020. ... ...

Abstract	ObjectiveWe aim to determine the psychological status of medical students during the COVID-19 outbreak and civil war in Libya.MethodsA cross-sectional study was conducted among medical students from 15 medical schools between April 20 and May 1, 2020. The demographic characteristics, generalized anxiety disorder 7-item (GAD-7) scale, and patient health questionnaire (PHQ-9) results were collected.ResultsOf the 3,500 students, 2,430 completed the survey. The mean (± SD) score of anxiety symptoms determined by the GAD-7 was 7.2 (5.1). A total of 268 (11%) students had a GAD-7 score of ≥15, which is indicative of moderate to severe anxiety. A total of 1,568 (64.5%) students showed different degrees of anxiety: mild, 910 (37.5%); moderate, 390 (16%); and severe, 268 (11%). Anxiety was significantly associated with living status and internal displacement (P < 0.05). The mean (+ SD) score of depressive symptoms determined by the PHQ-9 was 9.7 (6.3). A total of 525 (21.6%) students had a PHQ-9 score of ≥15, which is indicative of moderate to severe depression. A total of 1,896 (88%) students were diagnosed with mild (PHQ ≥ 5) depression. Suicidal ideation was present in 552 patients (22.7%). Depression was only statistically associated with the year of study (P = 0.009).ConclusionThese data highlight that medical students in Libya are at risk for depression, especially under the current stressful environment of the civil war and the COVID-19 outbreak.
Keywords	depression ; PHQ-9 ; anxiety ; GAD-7 ; medical student ; COVID-19 ; Psychology ; BF1-990 ; covid19
Subject code	150
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Impact of the COVID-19 Pandemic on Cardiologists in a Country with Limited Resources

Muhammed Elhadi / Ahmed Alsoufi / Mohamed Abrahim Bin Zarti / Siraj Abulmida / Nafati Alnafati / Najwa Alfurjani / Ahmed Khaled / Munder Mansour / Ahmed Msherghi / Ahmed Tarek / Hazem Abdelkarem Faraj

Global Heart, Vol 15, Iss

2020 Volume 1

Keywords	covid-19 ; sars-cov-2 ; cardiology ; interventional ; healthcare workers ; ppe ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Public aspects of medicine ; RA1-1270 ; covid19
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementation of the ABCDEF Bundle for Critically Ill ICU Patients During the COVID-19 Pandemic

Keibun Liu / Kensuke Nakamura / Hajime Katsukawa / Peter Nydahl / Eugene Wesley Ely / Sapna R. Kudchadkar / Kunihiko Takahashi / Muhammed Elhadi / Mohan Gurjar / Be Kim Leong / Chi Ryang Chung / Jayachandran Balachandran / Shigeaki Inoue / Alan Kawarai Lefor / Osamu Nishida

Frontiers in Medicine, Vol

A Multi-National 1-Day Point Prevalence Study

2021 Volume 8

Abstract: Background: Data regarding delivery of evidence-based care to critically ill patients in Intensive Care Units (ICU) during the COVID-19 pandemic is crucial but lacking. This study aimed to evaluate the implementation rate of the ABCDEF bundle, which is a ...

Abstract	Background: Data regarding delivery of evidence-based care to critically ill patients in Intensive Care Units (ICU) during the COVID-19 pandemic is crucial but lacking. This study aimed to evaluate the implementation rate of the ABCDEF bundle, which is a collection of six evidence-based ICU care initiatives which are strongly recommended to be incorporated into clinical practice, and ICU diaries for patients with and without COVID-19 infections in ICUs, and to analyze the impact of COVID-19 on implementation of each element of the bundle and independent associated factors.Methods: A world-wide 1-day point prevalence study investigated the delivery of the ABCDEF bundle and ICU diary to patients without or with COVID-19 infections on 27 January 2021 via an online questionnaire. Multivariable logistic regression analysis with adjustment for patient demographics evaluated the impact of COVID-19 and identified factors in ICU administrative structures and policies independently associated with delivery.Results: From 54 countries and 135 ICUs, 1,229 patients were eligible, and 607 (49%) had COVID-19 infections. Implementation rates were: entire bundle (without COVID-19: 0% and with COVID-19: 1%), Element A (regular pain assessment: 64 and 55%), Element B (both spontaneous awakening and breathing trials: 17 and 10%), Element C (regular sedation assessment: 45 and 61%), Element D (regular delirium assessment: 39 and 35%), Element E (exercise: 22 and 25%), Element F (family engagement/empowerment: 16 and 30%), and ICU diary (17 and 21%). The presence of COVID-19 was not associated with failure to implement individual elements. Independently associated factors for each element in common between the two groups included presence of a specific written protocol, application of a target/goal, and tele-ICU management. A lower income status country and a 3:1 nurse-patient ratio were significantly associated with non-implementation of elements A, C, and D, while a lower income status country was also associated with implementation ...
Keywords	ABCDEF bundle ; COVID-19 ; ICU diary ; ICU liberation bundle ; pandemic (COVID-19) ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya

PLoS ONE, Vol 16, Iss 4, p e

A prospective multi-center cohort study.

2021 Volume 0251085

Abstract: Background The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors ...

Abstract	Background The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in-ICU mortality rate. Methods This is a multicenter prospective observational study among COVID-19 critical care patients in 11 ICUs in Libya from May 29th to December 30th 2020. Basic demographic data, clinical characteristics, laboratory values, admission Sequential Organ Failure Assessment (SOFA) score, quick SOFA, and clinical management were analyzed. Result We included 465 consecutive COVID-19 critically ill patients. The majority (67.1%) of the patients were older than 60 years, with a median (IQR) age of 69 (56.5-75); 240 (51.6%) were male. At 60 days of follow-up, 184 (39.6%) were discharged alive, while 281 (60.4%) died in the intensive care unit. The median (IQR) ICU length of stay was 7 days (4-10) and non-survivors had significantly shorter stay, 6 (3-10) days. The body mass index was 27.9 (24.1-31.6) kg/m2. At admission to the intensive care unit, quick SOFA median (IQR) score was 1 (1-2), whereas total SOFA score was 6 (4-7). In univariate analysis, the following parameters were significantly associated with increased/decreased hazard of mortality: increased age, BMI, white cell count, neutrophils, procalcitonin, cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin, and d-dimer levels were associated with higher risk of mortality. Decreased lymphocytes, and platelet count were associated with higher risk of mortality. Quick SOFA and total SOFA scores increase, emergency intubation, inotrope use, stress ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610 ; 310
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of anxiety and depressive symptoms among emergency physicians in Libya after civil war

Muhammed Elhadi / Ala Khaled / Ans Bassam Malek / Ahmed El-Alem El-Azhari / Ahmed Zakaria Gwea / Ahmed Zaid / Salman Mabruk Elturki / Ahmed Aburgegah / Munir Ahmed K Abu Ageila / Abdulmueti Alhadi / Hafed Abdulwahhab Albashkar / Aliyah Mustafa Alshareef / Adel Basher Ben Nama / Nizar Aljarboue Mohammed Sahboun / Hazem Ahmed

BMJ Open, Vol 10, Iss

a cross-sectional study

2020 Volume 8

Keywords	Medicine ; R
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Impact of the COVID-19 pandemic on medical education

PLoS ONE, Vol 15, Iss 11, p e

Medical students' knowledge, attitudes, and practices regarding electronic learning.

2020 Volume 0242905

Abstract: The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as ... ...

Abstract	The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education. A cross-sectional survey was conducted with medical students from more than 13 medical schools in Libya. A paper-based and online survey was conducted using email and social media. The survey requested demographic and socioeconomic information, as well as information related to medical online learning and electronic devices; medical education status during the COVID-19 pandemic; mental health assessments; and e-learning knowledge, attitudes, and practices. A total of 3,348 valid questionnaires were retrieved. Most respondents (64.7%) disagreed that e-learning could be implemented easily in Libya. While 54.1% of the respondents agreed that interactive discussion is achievable by means of e-learning. However, only 21.1% agreed that e-learning could be used for clinical aspects, as compared with 54.8% who disagreed with this statement and 24% who were neutral. Only 27.7% of the respondents had participated in online medical educational programs during the COVID-19 pandemic, while 65% reported using the internet for participating in study groups and discussions. There is no vaccine for COVID-19 yet. As such, the pandemic will undeniably continue to disrupt medical education and training. As we face the prospect of a second wave of virus transmission, we must take certain measures and make ...
Keywords	Medicine ; R ; Science ; Q
Subject code	370
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Knowledge, attitude, and acceptance of healthcare workers and the public regarding the COVID-19 vaccine

Muhammed Elhadi / Ahmed Alsoufi / Abdulmueti Alhadi / Amel Hmeida / Entisar Alshareea / Mawadda Dokali / Sanabel Abodabos / Omaymah Alsadiq / Mohammed Abdelkabir / Aimen Ashini / Abdulhamid Shaban / Saja Mohammed / Nehal Alghudban / Eman Bureziza / Qasi Najah / Khawla Abdulrahman / Nora Mshareb / Khawla Derwish / Najwa Shnfier /

Rayan Burkan / Marwa Al-Azomi / Ayman Hamdan / Khadeejah Algathafi / Eman Abdulwahed / Khadeejah Alheerish / Naeimah Lindi / Mohamed Anaiba / Abobaker Elbarouni / Monther Alsharif / Kamal Alhaddad / Enas Alwhishi / Muad Aboughuffah / Wesal Aljadidi / Aisha Jaafari / Ala Khaled / Ahmed Zaid / Ahmed Msherghi

BMC Public Health, Vol 21, Iss 1, Pp 1-

a cross-sectional study

2021 Volume 21

Abstract: Abstract Background This study determined the knowledge, attitudes, and practice regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among healthcare workers and the general population. Methods A web-based, cross-sectional study was ... ...

Abstract	Abstract Background This study determined the knowledge, attitudes, and practice regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among healthcare workers and the general population. Methods A web-based, cross-sectional study was conducted using convenience sampling in Libya from December 1 to 18, 2020 among the general population and healthcare workers. Data on demographic characteristics, COVID-19 vaccination-related concerns, knowledge, attitudes, and practice regarding COVID-19, and knowledge, attitudes, and acceptance regarding the COVID-19 vaccine were collected using a self-administered survey. A binomial logistic regression was performed with 70% efficacy to determine the association between acceptance of the vaccine and study variables. Results Valid and complete responses were collected from 15,087 participants. Of these, 6227 (41.3%) were male and 8860 (58.7%) were female, with a mean (SD) age of 30.6 ± 9.8 years. Moreover, 485 (3.2%) participants were infected with COVID-19 at the time of the study, while 2000 (13.3%) had been previously infected. Overall, 2452 (16.3%) participants agreed, and 3127 (20.7%) strongly agreed, with “having concerns about serious vaccine-related complications.” Mask-wearing adherence was reported by 10,268 (68.1%) of the participants. Most participants (14,050, 93.1%) believed that the vaccine should be provided for free, while 7272 (48.2%) were willing to buy it. Regarding vaccine acceptance and efficacy, 12,006 (79.6%) reported their willingness to take the vaccine with an efficacy of 90% or more, 9143 (60.6%) with an efficacy of 70% or more, and only 6212 (41.2%) with an efficacy of 50%. The binomial logistic regression revealed that vaccine acceptance was not associated with belonging to the medical field versus the general population. Acceptance was statistically associated with younger age groups, especially 31–40 (OR = 1.3 [1.09, 1.55]) and 41–50 years (OR = 1.29, [1.09, 1.54]). However, having a family member or friend infected with COVID-19 ...
Keywords	COVID-19 ; SARS-CoV-2 ; Vaccine ; Acceptance ; Knowledge ; Attitude ; Public aspects of medicine ; RA1-1270
Subject code	300
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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