Mogadishu University

Background:Myocardial bridging (MB) is a congenital coronary artery anomaly in which a segment of an epicardial coronary artery, most commonly the left anterior descending (LAD) artery, courses intramyocardially, and undergoes systolic compression. Although historically regarded as a benign anatomical variant, myocardial bridging has increasingly been recognized as a potential cause of myocardial ischemia, exertional chest pain, and other cardiac symptoms, particularly in patients without obstructive coronary artery disease. Awareness of this condition is important, as its diagnosis and management differ from those of atherosclerotic coronary disease.Case presentation:We report 2 cases of symptomatic myocardial bridging involving the mid-segment of the LAD artery. The first case involved a 35-year-old male with a 2-month history of exertional chest pain and no cardiovascular risk factors. Initial evaluation, including electrocardiography, cardiac biomarkers, and transthoracic echocardiography, was unremarkable. Coronary angiography demonstrated a myocardial bridge in the mid-LAD with systolic compression and normal diastolic filling, without evidence of obstructive coronary artery disease. The patient was treated with diltiazem, resulting in complete symptom resolution at 1-month follow-up. The second case involved a 48-year-old male with a history of smoking and well-controlled hypertension who presented with exertional chest pain radiating to the left arm, accompanied by palpitations. Laboratory investigations, electrocardiography, and echocardiography were normal. Coronary angiography again revealed myocardial bridging of the mid-LAD without obstructive lesions. Treatment with diltiazem led to complete symptom resolution, and the patient remained clinically stable at 2-month follow-up.Discussion:These cases highlight the clinical significance of myocardial bridging as a cause of angina-like symptoms in patients with non-obstructive coronary arteries. The pathophysiology is multifactorial and includes dynamic systolic compression, delayed diastolic relaxation, endothelial dysfunction, and increased susceptibility to ischemia during tachycardia. Medical therapy aimed at reducing heart rate and myocardial contractility, particularly with non-dihydropyridine calcium channel blockers, remains the cornerstone of management.Conclusion:Myocardial bridging should be considered in the differential diagnosis of chest pain in patients with normal coronary arteries. Early recognition and appropriate medical therapy can result in effective symptom control and may prevent unnecessary invasive interventions.

Somalia's recurring hunger crises are often viewed as emergencies that can be addressed by emergency food aid. In reality, chronic food insecurity now stems from structural fault lines-poverty, conflict, displacement, climate volatility, weak land tenure, under-resourced ministries, and fractured markets-that short-term food aid cannot repair. Today, 4.3 million Somalis face acute food insecurity, and more than 700,000 children are acutely malnourished, even though the country boasts a 3333-km coastline, fertile river valleys and a rich tradition of pastoralism and farming. Cycles of drought have decimated herds, forced pastoralists into urban slums, and eroded coping mechanisms, while conflict blocks access to productive land and drives up dependence on imports for over 80% of staple foods. Climate change is tightening this vise through erratic rains, scorching heat, and flash floods. To achieve sustainable food security, Somalia must shift from emergency relief to long-term investments in resilient and inclusive food systems. That means channelling at least five percent of public expenditure into irrigation, water harvesting, and extension services; securing land rights to spur on-farm investment; scaling early-warning and climate-smart technologies; and rebuilding rural infrastructure, cold chains, and digital marketplaces so smallholders can reach consumers. Nutrition gains hinge on diversifying production of fruits, vegetables, legumes, and animal proteins, linked to community health and education programs. A national Food Systems Coordination Council should align humanitarian and development actors with regional frameworks, while public-private partnerships unlock finance for Somali agribusiness innovations. Ending hunger is not only a humanitarian obligation; it is a prerequisite for stability, growth, and social justice. With political will, integrated governance, and sustained investment, Somalia can move beyond food aid, harness its land and heritage, and lay the foundation for a resilient, self-reliant future.

Diphtheria remains a life-threatening infectious disease in low- and middle-income countries, particularly where immunization coverage is incomplete. Severe complications such as myocarditis and acute kidney injury significantly increase mortality. Reporting rare and complex presentations is essential to improve early recognition and management. We report the case of a 6-year-old girl who presented to the emergency department with five days of aphonia, odynophagia, progressive dysphagia, fever, confusion, and oliguria. On examination, she had cervical lymphadenopathy, pharyngeal pseudomembranes, and signs of systemic toxicity. Laboratory investigations demonstrated acute kidney injury with metabolic acidosis. Echocardiography revealed myocarditis with reduced ventricular function. The patient had incomplete vaccination against diphtheria. She was treated with diphtheria antitoxin, antibiotics, and supportive critical care. Despite aggressive management, the case illustrates the severe systemic complications of toxic diphtheria. Diphtheria is transmitted primarily via respiratory droplets and direct contact with infected lesions. Children in settings with poor vaccine coverage are particularly vulnerable to severe disease. Myocarditis and renal failure are toxin-mediated complications and are the leading causes of death. This case highlights the importance of early diagnosis, laboratory confirmation, and immediate administration of antitoxin. This case underscores the ongoing threat of diphtheria in under-immunized populations. Prompt recognition and treatment are essential to prevent fatal complications. Strengthening routine immunization programs remains the most effective strategy to reduce diphtheria-related morbidity and mortality.

Abstract Faced with different readings of the Bible, justifying the oppression of the Palestinian, the Christian Palestinians reading of the Bible challenges those reading. This reading is contextual, inclusive, and Christological. The Christian Palestinians, the oldest Christian community, contribute through their reading of the Bible to justice, peace and reconciliation.

Social anxiety is a common and debilitating psychiatric condition marked by an intense fear of negative evaluation in social situations, leading to significant impairments in occupational, academic, and daily functioning. Among medical students, this fear can significantly impede essential interpersonal interactions and academic performance. Despite its clinical significance, social anxiety remains under-researched in low-resource contexts, including Somalia. This study aims to assess the distribution and severity of social anxiety symptoms and identify its associated factors among medical students in Mogadishu, thereby informing targeted mental health interventions. A cross-sectional study was conducted between April and May 2025 among 290 undergraduate medical students from six private universities in Mogadishu, Somalia. Data were electronically collected using a structured questionnaire and validated instruments, including the Social Phobia Inventory (SPIN), the Patient Health Questionnaire-9 (PHQ-9), the Oslo Social Support Scale-3 (OSSS-3), and the Rosenberg Self-Esteem Scale (RSES-10). Logistic regression analysis identified independent factors associated with social anxiety, sex differences were assessed via the Mann–Whitney U test, and associations with psychosocial variables were analyzed using Spearman’s rank-order correlation. Statistical significance was set at a p-value < 0.05. Of the 290 participants, 35.5% (95% CI: 30.0–41.3) met the criteria for social anxiety. Female students (AOR = 1.79; 95% CI: 1.03–3.14) and those who reported physical inactivity (AOR = 2.33; 95% CI: 1.17–4.61) had significantly higher odds of social anxiety. Psychosocial factors significantly associated with social anxiety included low self-esteem (AOR = 2.87; 95% CI: 1.19–6.95), depressive symptoms (AOR = 5.61; 95% CI: 2.91–10.82), poor social support (AOR = 2.33; 95% CI: 1.15–4.73), and parental criticism (AOR = 2.22; 95% CI: 1.20–4.13). This study demonstrates a high level of social anxiety among medical students in Mogadishu, Somalia, and identifies significant associations with demographic, behavioral, and psychosocial factors. The results underscore the importance of enhancing mental health awareness and psychoeducation within medical schools, alongside supportive and preventive approaches that address modifiable factors such as physical inactivity, low self-esteem, depressive symptoms, and limited social support. Strengthening general mental health literacy and supportive environments may contribute positively to students’ well-being and academic experiences and support the long-term resilience of the future medical workforce.

IntroductionThe global development discourse primarily emphasizes the vital role of international aid in post-conflict health systems and governance. Somalia’s post-conflict health recovery has relied heavily on multisectoral aid that saved lives but entrenched parallel systems. While the national budget rose from ~ SOS 200 million (2015) to ~ SOS 1.3 billion (2025), the Ministry of Health’s share remained ≤ 7%, leaving sustainability and local ownership at risk. Recent funding cuts have reduced food, health, and WASH services, heightening disease and malnutrition risks. This review examines the long-term impacts of multisectoral aid on Somalia’s health system and governance, focusing on its effectiveness, sustainability, and unintended consequences.MethodWe conducted a narrative review (1990–2024; final search April 25, 2025) across PubMed, Scopus, Web of Science, Google Scholar, and gray literature (WHO, UNICEF, World Bank, USAID, FMoH). Using SANRA guidance, two reviewers screened 221 records plus prior evidence; 334 studies/reports were synthesized via hybrid thematic coding (NVivo) across five domains: aid-driven system development; aid–governance interactions; consequences of dependency; comparative insights; and sustainability pathways.ResultsAid delivered tangible “fruits”: expanded immunization and MCH coverage; high 2024 delivery performance (health 95% with US$69.8 M spent; nutrition 95.5% with US$73.9 M); and total donor inflows of ~ US$721.9 M fully deposited. However, most funds flowed off-budget through vertical programs and parallel supply/data chains, fragmenting governance and dampening state capacity. Despite the health share peaking at 7% (2023) and stabilizing near 6.8% (2025), cuts in 2025 curtailed essential services, leaving millions more vulnerable. Comparative cases (Liberia, Sierra Leone vs. South Sudan, Afghanistan) show sustainability improves when pooled funding, government payroll integration, and PHC-first strategies are adopted.ConclusionFor Somalia to transition from aid dependency to sustainable health governance, a deliberate shift is needed by strengthening FMoH leadership, funding PHC, unifying systems, integrating staff into public payroll, and ensuring epidemic readiness.

Vascular Dementia (VaD) is a significant public health burden globally and nationally, especially in countries with rapidly aging populations such as Indonesia. This systematic review aims to synthesize the latest evidence on the association between modifiable vascular risk factors and the incidence of VaD in the elderly population. This systematic review was conducted in accordance with the PRISMA 2020 guidelines. The methodological quality of the included studies was critically assessed using the NOS. Data synthesis was performed narratively due to anticipated heterogeneity in study methodologies. These findings underscore the importance of cumulative exposure to vascular risk factors throughout life, with middle age being a critical window for preventive intervention. These risk factors do not act in isolation but converge on common pathophysiological pathways such as endothelial dysfunction, blood-brain barrier disruption, and neuroinflammation, which collectively drive cerebrovascular damage and cognitive decline. This study demonstrates that vascular risk factors are significantly associated with VaD, with increased exposure to conditions such as hypertension, diabetes mellitus, dyslipidemia, and an unhealthy lifestyle contributing to cognitive impairment. Future studies are recommended to use a prospective design with a larger sample size and standardized diagnostic methods to increase the validity of the results. AbstrakDemensia Vaskular (VaD) merupakan beban kesehatan masyarakat yang signifikan secara global dan nasional, terutama di negara dengan populasi lansia yang meningkat pesat seperti Indonesia. Tinjauan sistematis ini bertujuan untuk mensintesis bukti-bukti terkini mengenai asosiasi antara faktor risiko vaskular yang dapat dimodifikasi dengan kejadian VaD pada populasi lansia. Tinjauan sistematis ini dilakukan sesuai dengan pedoman PRISMA 2020. Kualitas metodologis dari studi yang diinklusi dinilai secara kritis menggunakan NOS. Sintesis data dilakukan secara naratif karena heterogenitas yang dian tisipasi dalam metodologi studi. Temuan ini menggarisbawahi pentingnya paparan faktor risiko vaskular kumulatif sepanjang hidup, dengan periode usia paruh baya menjadi jendela kritis untuk intervensi preventif. Faktor risiko ini tidak bekerja secara terisolasi, melainkan berkonvergensi pada jalur patofisiologis umum seperti disfungsi endotel, kerusakan sawar darah-otak, dan neuroinflamasi, yang secara kolektif mendorong kerusakan serebrovaskular dan penurunan kognitif. Penelitian ini menunjukkan bahwa faktor risiko vaskular memiliki hubungan yang signifikan terhadap kejadian VaD, dimana peningkatan paparan terhadap kondisi seperti hipertensi, diabetes melitus, dislipidemia, dan gaya hidup tidak sehat berkontribusi terhadap terjadinya gangguan fungsi kognitif. Penelitian selanjutnya disarankan menggunakan desain prospektif dengan sampel yang lebih besar serta metode diagnosis yang terstandarisasi untuk meningkatkan validitas hasil.

The global population is increasing rapidly, with projections for suggesting this will rise to 60% by 2030 and 70% by 2050. Africa’s long-term vision aligns with Agenda 2063 and Somalia’s development trajectory, including the launch of its National Transformation Plan (NTP) for 2025–2029. This plan highlights the country’s evolving national development strategies, from the post-independence National Development Plans (NDPs) to more recent frameworks. Despite ambitious goals, previous plans have struggled due to institutional fragility, political instability, and heavy reliance on external aid. Somalia, located on the Horn of Africa, has faced numerous challenges, including conflict, climate vulnerability, and economic stagnation, which have hindered long-term progress. The paper traces Somalia’s historical development journey and offers a comprehensive review of how past lessons can inform future planning. The NTP 2025–2029 marks a significant shift in Somalia’s approach to national development. For the first time, the country adopts a participatory, systems-based methodology through the Lab Approach. This approach integrates multiple stakeholders, including federal and member state institutions, civil society, and international partners, to collaboratively design solutions tailored to Somalia’s unique needs. The NTP seeks to foster inclusive economic growth, resilient governance, and environmental sustainability, all aligned with the United Nations Sustainable Development Goals (SDGs) and the African Union’s Agenda 2063. This holistic transformation focuses on overcoming previous obstacles, such as weak institutions and fragmented governance. While NTP presents a forward-thinking framework, its successful implementation is contingent on overcoming significant challenges. The article highlights Somalia’s security threats, technical capacity gaps, and political fragmentation, suggesting strengthening institutional frameworks, enhancing fiscal autonomy, and prioritizing climate resilience through robust monitoring and stakeholder engagement. The NTP aims for a prosperous, democratic, and resilient Somalia by 2029, providing a clear and actionable roadmap for the country’s long-term development and stability.