https://www.doi.org/10.37375/issn.2957-3572 Sirte University Journal of Medical Sciences, a semi-annual refereed medical journal specialized in publishing research and scientific articles in the field of Medicine, Dentistry and Health sciences. It was established by a decision of the University President No. (12) For the year 2021 on 04/05/2021, and the Journal obtained the legal deposit number (991/ 2021) from the National Library. Through the journal, scientific medical research is published, which aims to see the latest medical research and studies and how to deal with diseases and causes, treat them and limit their spread. The Journal targets specialists and specialists in the field of medical and allied sciences to include all medical fields in medicine, dentistry, nursing, applied medical sciences, pharmacy and public health, in addition to researchers in the field of medical sciences. The journal is pleased to invite all researchers to publish their scientific research in it to enrich scientific research in the field of medical sciences.
Demographic and clinical variants of lichen planus: a retrospective study [Retracted Article]
Background: Lichen planus is a group of chronic inflammatory diseases affecting stratified squamous epithelia. Objective: To determine the demographic characteristics, the clinical variants, and the site involvement and to compare the study results with the findings of the literature. Materials and method: This study was based on the retrospective analysis of the medical files of patients who attended an two private clinics in Almansoora district, Aden, between the years of 2019 – 2020. SPSS 17 was used. Data were analyzed using descriptive statistics and chi-square test. P < 0.05 was considered statistically significant. Results: The study patients were 102 (62.2%) females and 62 (37.8%) males. The age ranged between 20 – 60 years. The age group 41 – 50 had the highest number of patients 56 (34.1%). The involvement of skin only was observed in (58.6%) patients. Concomitant involvement of mucous membranes with skin was seen in (16.3%) patients, nails with skin in (7.3%), face in (6.1%) and skin + mucous membranes + nail in (4.9%) patients. Penis involvement was found in (2.4%) male patients and scalp involvement in (2.4%) female patients. Classic variants of lichen planus were predominant in (63.4%) patients followed by hypertrophic lichen planus in (15.9%), and pigementosus lichen planus in (11.0%) patients (p = 0.001). Koebner phenomenon found in (18.3%) patients with lichen planus. The arterial hypertension found in (11.0%) patients followed by diabetes mellitus in (8.6%) patients and hepatitis c in (2.4%) patients. Conclusion: Most affected patients of lichen planus were the age group 41 – 50 years old, followed by the age group > 50 years old. Further studies are need to determine the prevalence of this skin disorders among residents of Aden governorate.
Prevalence of Anaemia amongst non-pregnant women in Sirte at Ibn-Sina hospital over a period of ten years (2010-2020)
Background: The World Health Organization (WHO) has reported that in 2019, 30% (539 million) of non-pregnant women were affected by anemia, with the highest prevalence in sub-Saharan Africa and Asia. Anaemia remains a major public health concern in developing countries, as it can affect individuals at any stage of life. The symptoms of anaemia are non-specific and can lead to reduced physical work capacity and productivity. The aim of the study is to estimate the prevalence of anaemia in non-pregnant women residing in Sirte City. Methods: This is a retrospective observational study that took place at Iben Sina Teaching Hospital in Sirte, Libya. The study included all case records of women above the age of 15 years who were admitted to the female medical ward at the hospital in the period between 2010 and 2020. The data was examined using Microsoft Excel 2019 and presented in tables and graphs. Results: The case records of 773 cases were reviewed and analyzed. The results revealed an estimated anemia (Hb <12g/dl) prevalence of 14.7% (114/773), the mean age of patients was 55 years and the mean Hb was 6.5 g/dl. Conclusion: The study showed that anaemia is prevalent in the admitted female population in the city of Sirte and a notable increase was noted in the last year of the study that could reflect capturing the real prevalence; this must be confirmed in subsequent studies that would also help in identifying risk factors and causes in this female population
Prevalence of UTI Caused by Gram-Negative Bacteria in Type 2DM Cases at Khoums Diabetes Center in Al-khoums, Libya.
Urinary tract infections (UTIs) are more frequent, more severe, and have worse outcomes in individuals with type 2 diabetes mellitus. These infections are also more commonly caused by resistant pathogens. Several factors, including immune system dysfunction, poor metabolic control, and incomplete bladder emptying due to autonomic neuropathy, may contribute to the increased risk of UTIs in these patients. A prospective study was carried out at Khoums Diabetes Center in Al-Khoms, Libya, from December 2022 to February 2023. The study included 170 participants, 140 of whom were diagnosed with type 2 diabetes, while 30 were non-diabetic (control group). Among the 140 urine samples from diabetic patients, 60 samples (42.9%) showed significant bacterial growth, while 80 samples (57.1%) showed no significant growth. When examining the relationship between liquid intake, socio-economic status, and Gram-negative bacterial species, the data was categorized by sex, age, weight, and employment. A higher percentage of females (84%) were affected compared to males (16%). The age group most affected was 46-55 years, comprising 35.5% of cases. Regarding employment, housewives were the most affected group, making up 67.8%, while laborers had the lowest incidence, with 0%. Improving the management of diabetes mellitus, along with the proper use of antibiotics selected based on sensitivity patterns, could help reduce the prevalence of urinary tract infections (UTIs) and prevent renal complications. The results highlighted the rise of highly resistant bacteria to most of the tested antimicrobials, urging physicians to adjust their treatment approaches based on antimicrobial susceptibility findings
The Attitude and willingness towards COVID-19 Vaccine in healthcare workers in Sirte, Libya
Healthcare workers (HCWs) are among the groups that were at the forefront of the Corona epidemic. Many of them became infected and sometimes died. Since they are among the most vulnerable to this epidemic, they were among those targeted for the Covid-19 vaccination. This an observational cross-sectional study aims to evaluate the knowledge and attitudes of health care workers at Ibn Sina Hospital in the city of Sirte regarding vaccination against the Coronavirus, and how demographic, professional, or other factors may be affected by differences in knowledge and attitudes related to acceptance of taking the Coronavirus vaccine. The study was targeted 155 participants (mean age 1.97, male 73 (47.1%), female 82 (52.9%). Those who agreed to take the vaccination were (77) and represented (49.7%). Those who did not agree to take the vaccination and answered no were (58) and represent (37.4%). There were (20) of those who were not interested and were hesitant about taking the vaccination or not, representing (12.9%) of the total number in this study.
Prevalence of intestinal parasites among gastrointestinal patients in Hun City, Libya: A cross-sectional study
Background:This cross-sectional study aimed to assess the prevalence and distribution of intestinal parasites among patients attending Al-Masra'a Clinic in Hun city, Aljufra, Libya,from January 2021 to December 2023.. Methods:A total of 1,079 stool samples were collected from gastrointestinal patients. Sociodemographic data and risk factors were gathered using a structured questionnaire. Stool samples were examined using light and dark ground microscopy, direct smear techniques with normal saline and Lugol’s iodine, and the formalin-ether concentration technique. Ziehl-Nielsen staining was used for microscopic differentiation of parasite developmental forms. Data were analysed using SPSS (version 24), with descriptive statistics and Chi-square tests employed to identify significant associations. Results:Intestinal parasites were detected in 13.3% (144/1,079) of the patients, with a significant difference (P=0.02). Males had a higher infection rate (68.75%) compared to females (31.25%), with a significant difference (P=0.04). The highest prevalence was observed in individuals under 20 years (48.6%), followed by the 20-40 age group (22.2%). Entamoeba histolytica was the most common parasite (73.61%), followed by Giardia lamblia (10.41%) and Entamoeba coli (7.63%). Co-infections were rare (6.25%). The prevalence of infections declined over the study period, from (11.6%) in 2021 to (7.4%) in 2023 (P=0.02). Rural areas had a significantly higher prevalence (84.02%) compared to urban areas (15.97%), with a significant difference (P=0.04). Conclusion:The study highlights the need for targeted public health interventions, particularly in rural areas, to improve sanitation, health education, and access to healthcare. Enhanced water quality and hygiene practices are crucial to reducing the burden of intestinal parasitic infections in the region.
Prevalence of Hernia in Sirte, Libya: A Literature Review and Comparison with Western Countries
Inguinal hernias are the most prevalent in females, according to several sources in the western medical literature, followed by femoral and peri-umbilical hernias. However, our data in Sirte show that peri-umbilical hernias are the most common among females, with inguinal and femoral hernias lagging far behind. As a result, our Sirte data analysis differs significantly from those seen in journals and western medical texts. The article takes a critical approach on the causes behind the difference and explores the relevant literature.
Pregnancy out comes after assisted reproductive technology (Derna / Libya)
Background: Studies the outcome of pregnancy after assisted reproductive technologies (ART) pregnancies report heterogeneous results. Despite the success of ART to overcome infertility, concern is growing regarding both its safety and its effect on maternal and child health. objective: The aim of this study is evaluation of pregnancy outcome (maternal and fetal) after ART. Methods: A population-based birth prospective cross- section observational study was carried out among pregnant women by ART & expected to deliver in 2020 to 2022 at Al wahda hospital / Derna, maternal results included gravidity difficulties and weight gain during pregnancy. Results: The study includ 100 pregnant women after ART. Adjusted examines displayed that, more than 90% of pregnancies were multiple pregnancy. The OHSS was positive in 45.0%. The majority of the patients (97.0%) had anemia during pregnancy. The cervical cerculage done in 46.0% of the pregnant women. Conclusion: the major bad effect on the child-health results is owing mostly to the increase occurrence of several pregnancies and not because of ART.
Awareness and Knowledge of Cervical Cancer Among Female Students and Graduates of Public Health Faculty: Opportunities for Prevention and Early Detection in Developing Countries
Background: Cervical cancer (CC) is a preventable and treatable gynaecological disease. Preventive medicine plays an essential role in the reduction of CC morbidity and mortality rates. Healthcare workers in developing countries have not demonstrated a comprehensive awareness and knowledge of CC prevention and early detection. Objective: The aim of this study is to examine the awareness about CC and its risk factors and describe the level of knowledge for role of Human Papilloma Virus (HPV) infection in CC and the use pap smear screening tests among female students and graduates at the Faculty of Public Health at the University of Benghazi, Libya. Participants and Methods: A cross-sectional, descriptive study was conducted during the period 14th and 25th of July 2024, targeting the female students and graduates of Public Health Faculty in Benghazi- Libya. Ethical approval was obtained from the ethical committee of the faculty. Sample size was calculated to be 360 participants. Consents of participation were obtained. The questionnaire was distributed to students (year one to year four and to the graduates) answers collected through Google form. We started analysis when the desired sample size reached nearly equal distributions between the four years students and the graduates. The questionnaire consisted of two parts: socio-demographic characteristics, (age, year of study, role at faculty (students or graduates), and marital status). The second part consisted of knowledge about CC causes, risk factors, awareness about HPV (sexually transmitted infection, types associated with CC and vaccination). Pap smear as screening test for early detection of cervical changes. Personal practice through asking about receiving HPV vaccination, enumerating the common barriers to implement CC prevention programs, SPSS version 27 was used
Estimation of Plasma Triglyceride Level among Patients with Diabetes Mellitus, Wad Medani, Gezira State, Sudan, in 2022
Background: In Sudan and around the world, Diabetes Mellitus is a growing health concern. It is a serious, ongoing condition. The Middle East and North Africa area (MENA) area, which includes Sudan, has the world's highest prevalence of diabetes. It was predicted to be about 25%. More concerning is the prediction that by 2030. Patients and Methods: This is a case control study conducted in Aldaraga Health Center for Diabetes Care and Wad Medani Pediatric Teaching Hospital, Wad Medani, Gezira State, Sudan to estimate the plasma triglyceride level among diabetic patients. A total of 160 participants were included in the study, ninety patients were case group (Diabetic patients), their mean age was (40.90±24.00) years and seventy were control group (Healthy individuals) their mean age was (45.78±22.38) years. Among case, 37 (41%) were males while 53 (59%) were females. Data were collected by using questionnaire and analyzed by computer program SPSS (Version 20). After fasting (8-12) hours, 2 ml of heparinized plasma and 1.5 ml EDTA whole blood was collected for estimation of triglyceride and HbA1c respectively and then plasma was stored at -200C till assay was done by Cobas C 311. Results: It revealed high rate of poor glycemic control in Sudanese diabetic patients (81%). There were significance differences in plasma triglyceride between diabetic patients and control group (P value =0.002), age groups (P value =0.000), and gender (P value =0.019). However, there were no statistically significant differences when compared plasma triglyceride levels with glycosylated hemoglobin and duration of the disease (P values = 0.514 and 0.096 respectively). Conclusion: Diabetes, age, and gender, but not glycosylated hemoglobin or disease duration, were found to have an impact on triglyceride levels in this study.
Evaluation of Hematological Changes in The Pregnant Women in EL-Beyda City- Libya
Background: Pregnant women normally undergo to several hematological changes perhaps anemia is considered the significant one. It is a major public health problem and commonly associated with many consequences as low birth weight, premature delivery and the increased risk of the maternal mortality and morbidity in the pregnant women, mainly in the developing countries .The aim of the study: The present study was designed to estimate the changes in hematological parameters in women during pregnancy at EL-Beyda City. Methods: Cross sectional study involved 350 randomly selected pregnant mothers who are attended several medical clinics in the period of February to July 2022, of age group 17-48 years. A venous blood samples were collected in EDTA tubes and analyzed for complete blood counts (CBC) to evaluate hemoglobin levels (Hb), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), white blood cells (WBCs) and platelets count. Other data were also reported including women age, trimester of pregnancy, the number of the gravida and the parity. Results were obtained by analyzing collected data by SPSS version 26 and represented as mean ± SE and P value is considered significant when it is less than 0.05. The Results: The mean age of the participants women was 29.5(±0.33), the overall prevalence of anemia was 57% and vast of them were in third trimester period. Out of 204 anemic women, 109 (53.4%) of them had normocytic normochromic anemia (mean of MCV 88fl). while the rest 94 (46%) were suffered microcytic hypochromic anemia (mean of MCV 72fl). The present investigation was revealed that the mean of hemoglobin of anemic women was 9.84±0.06. which are significantly different in the mean of non-anemic women (p value =0.000) as well as majority of women 165 (81 %) had mild anemia (Hb= 9-10.9 g/dl). Conclusion: We can conclude that the prevalence of anemia in Libya in the studied population is considerably high in comparison to other countries, therefore the great awareness efforts are recommended to encourage a regular antenatal checkups
Optimizing Dental Implant Outcomes: A Comprehensive Approach to Preventing and Managing Peri-Implantitis
Background: Peri-implantitis, a progressive inflammatory condition affecting dental implants, poses a significant threat to the long-term success of implant therapy. This study aimed to develop a comprehensive protocol for the prevention and management of peri-implantitis, integrating various preventive and therapeutic interventions. Methods: A multi-center, prospective, randomized controlled trial was conducted, involving 492 participants randomly assigned to five study groups: control, preventive intervention 1 (surface modification), preventive intervention 2 (patient education), therapeutic intervention 1 (regenerative techniques), and therapeutic intervention 2 (adjunctive antimicrobial therapies). Clinical assessments, including periodontal parameters, marginal bone levels, and patient-reported outcomes, were evaluated over a 5-year follow-up period. Results: All intervention groups showed significantly greater improvements in periodontal parameters, marginal bone levels, and patient-reported outcomes compared to the control group (p < 0.05). The therapeutic intervention group 1 (regenerative techniques) demonstrated the most favorable outcomes, with the greatest reductions in probing depth, clinical attachment level, bleeding on probing, and plaque index, as well as the smallest marginal bone loss and highest implant survival rate (94.2%). Participants in this group also reported the highest oral health-related quality of life, lowest pain and discomfort levels, and highest satisfaction with treatment outcomes. Conclusion: The findings highlight the efficacy of various preventive and therapeutic interventions in optimizing dental implant outcomes and improving patient quality of life. The multidisciplinary approach adopted in this study contributed to the development of a comprehensive protocol for the prevention and management of peri-implantitis, integrating cutting-edge research and evidence-based practices
Mortality Rate in the Neonatal Intensive Care Unit at IBN SINA Teaching Hospital Sirte-Libya
Studying the mortality rate of newborns in the neonatal intensive care unit (NICU) is of paramount importance as it provides valuable insights into the effectiveness of medical interventions, clinical practices, and healthcare strategies aimed at reducing infant mortality. By analyzing the mortality data, healthcare professionals can identify areas for improvement, implement evidence-based practices, and develop targeted interventions to enhance the quality of care and ultimately save more infant lives, throughout one. Total number of newborns in hospital 4,369 number of death 44. The data focused on death certificates of neonates
Risks of Ovarian, Breast, and Uterine Corpus Cancer in Women Receiving IVF Treatment
Background A common treatment for infertility or genetic issues today is assisted reproductive technology (ART), which includes in vitro fertilization (IVF). Numerous studies have been done in this area in order to better understand the potential effects of this technique on women who undergo in vitro fertilization (IVF) and children born through IVF. This study is an updated meta-analysis to determine whether there is a causal relationship between different fertility treatments and ovarian, breast cancer. - Methods To reflect contemporary in vitro fertilization (IVF) practice, studies written during the last 20 years were included. Finding out whether women who receive hormonal reproductive treatment have an elevated risk of ovarian, breast cancer was the study's main objective. To find out if individual fertility therapies increased the risk of breast cancer, one of the secondary outcomes was to do so. Researcher observed first cancer diagnoses for ovarian, breast, and corpus uteri were compared to expected rates for each age, sex, and period. With the help of age, sex, and time-specific incidence rates, standardized incidence ratios (SIRs) were computed. Results On this subject, there are opposing viewpoints. According to some research, the risk of developing hormone-sensitive malignancies, such as ovarian, breast cancer, has somewhat increased. Breast cancer is one of the most common malignancies in women and the long-term use of IVF drugs can raise estrogen hormones and lead to excessive gene expression, increasing the risk of the disease. Conclusion There are a few dangers to be aware of as a result of the theory that lengthy IVF treatments may cause breast cancer in IVF candidates. Additionally, ovarian, breast cancer risk may be elevated in women with a favorable family history and associated inherited genes. The likely effects of the reproductive therapy approaches should therefore be explained to women who are candidates for IVF. Explained to women who are candidates for IVF.
In-hospital cardiac arrest epidemiology and intervention
Introduction: Sudden cardiac arrest (SCA) is the abrupt loss of all cardiac activities as a result of acute heart rhythm disturbance and cessation of respiration, it is the most critical condition that faces any healthcare system, and that requires accurate precise coordinated intervention to achieve a favourable outcome. The epidemiological figures and the survival rates of in-hospital cardiac arrest vary significantly between developed and developing countries owing to the availability of rapid response resuscitation teams and advanced healthcare facilities. This study dictated to examine the epidemiology and the intervention aspects of in-hospital cardiac arrest in the city of Sirte at Ibn Sina Teaching Hospital. Methods: This study is a cross-sectional survey, dedicated to examining the epidemiological and intervention data of in-hospital cardiac arrest at IBN SENA TEACHING HOSPITAL in the city of Sirte, used a data collection form that included details of interest, a total of 591 files for patients who were admitted to the intensive care unit during the study period, 50 cases of cardiac arrest were registered and included in this study for analysis. Results: a total of 50 cases, with an overall incidence of 5.4 cardiac arrests for every 1000 admissions. males were arrested more than females during the study period; 66% males (34 cases) and 32% females (16 cases), the age group that has the highest frequency of cardiac arrest was (>75 years old) group for both sexes, and almost all of the registered cases were in the ICU, even though only 23 cases 46% were resuscitated, respiratory system diseases were the most frequent aetiology for cardiac arrest during the study period, followed by trauma and came 3rd the cardiovascular system diseases, Concomitant comorbidity of HTN and DM represents the most frequent pre-arrest illnesses which, and finally the survival rates were zero. Very important data were missed/undocumented that could improve the survival rates in one way or the other
Routine blood tests as a crucial diagnostic tool for COVID-19
Routine laboratory tests are essential for identifying COVID-19 cases. Reviewing the clinical features of confirmed COVID-19 cases retrospectively can offer valuable insights, the data were collected from 240 files, which included all files from the beginning of the opening of the isolation center in first of June 2020, until the 30th of December 2021. Of the 240 cases, 100 cases were dead. Of survived cases, 54% were male and 46% were female. While the dead cases, 56% were male and 44% were female. In conclusion, the blood cell count plays a crucial role in both diagnosing and predicting the outcome of COVID-19, serving as a routine diagnostic tool. Low levels of leukocytes and differential white blood cell count can serve as indicators of a COVID-19 infection, while higher counts may indicate the progression of the disease. Conversely, lymphocyte and D-dimer levels do not provide diagnostic value but are indicative of the severity of COVID-19 cases.
Application of alvarado scoring system in diagnosis of acute appendicitis
Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during the early stages. There is still appreciable morbidity and occasionally mortality which may be related to failure of making an early diagnosis (1) As a result of their concern about these surgeons create for themselves 'a surgical security zone which allows them to accept a 15-30% negative laparotomy rate with impunity (2), Although various aids exist to facilitate more accurate diagnosis and reduce the rate of negative appendectomy, many are complex.Whereas simple scoring systems have been available for some time, they have not been widely tested. The aim of this study was conducted to assess one of these scoring systems which was described by Alvarado in 19851(1), by comparing it’s to the histopathology results of operated patients. This retrospective study of consecutive patients admitted to surgical ward at Benghazi Aljala hospital with suspicion of having acute appendicitis during the period of January 2008 to January 2010. The Alvarado scoring system was computed from admission notes and records correlated with histopathology, all cases with insufficient data or no histopathology result were excluded from the study Out of 153 patients 90 underwent appendectomy with the intention to treat appendicitis and dianosis was confirmed in 80 patients. Reliability of the system was assessed by calculating negative appendectomy rate and positive predictive value which was 85%, and the normal appendectomy frequency was 12%. Alvarado scoring system is easy, cheap, and useful tool in preoperative diagnosis of acute appendicitis and can work effectively in routine practice
Outcome of Surfactant Replacement Therapy in Premature Neonates in ICU of Ibn Sina Teaching Hospital of Sirte, Libya in Period Between May – 2019 to May – 2022
Introduction :Respiratory distress syndrome (RDS) is an acute lung disease of preterm babies caused by surfactant insufficiency . Decreased surfactant results in insufficient surface tension in the alveolus during expiration leading to alveolar collapse , atelectasis , impaired gas exchange , severe hypoxia and acidosis , leading to respiratory failure . Surfactant replacement therapy (SRT) is now accepted as the standard treatment of preterm babies with RDS . Objective : The objective of this study was to analyze the incidence and outcome of surfactant replacement therapy in preterm babies with RDS . Methodology : This is Quantitative retrospective study , conducted in Neonatal Intensive Care Units (NICU) of Ibn Sina Teaching Hospital , Sirte , Libya . Study duration was of three years period ( May – 2019 to May – 2022 ) . Preterm babies from 24 wks to 36 wks of gestation with RDS received SRT were included in this study . The surfactant was administrated intra- tracheally according to standard procedures . Results :In this study of 41 preterm babies with RDS received SRT , 30 ( 73.2% ) were male and 11 ( 26.8% ) were female . The mean gestational age was 33.12 weeks . Among 41 preterm babies with RDS receiving SRT , 21 ( 51.2% ) discharged from the hospital and 20 ( 48.8% ) expired . Maximum survival was seen in the gestational age of ≥32 wks and birth weight ≥ 1500 gms . Conclusion : The use of SRT has improved the survival outcome and decreased the associated morbidities in babies with RDS . The maximum impact of survival was seen in the oreterm babies of ≥ 32 weeks with birth weight of ≥ 1500 grams .
Infection rate of Enterobius vermicularis ( Pinworm) among school children in Sebha, Libya.
Helminthic infections caused by Enterobius vermicularis have a cosmopolitan character and most often affect the paediatric pre-school and school age population. This helminth is the most frequent in Libya, but it is as yet unrecognized, probably due to parasitological laboratories not being consulted. The cellophane scotch tape method was used to investigate the presence of E. vermicularis eggs in 115 specimens. The overall infection of this parasite was 11.3%.Out of 115 school children (62 boys and 53 girls) nine (14.51%) boys, and four (7.54%) girls, were found infected with this parasite. There was a significant difference (X2=5.39, P=0.022) between both genders. Highest prevalence rate (13.84%), was found among 8 to10 years old age group. The adhesive scotch tape method appeared to be sensitive and appropriate choice to diagnose infection of E. vermicularis..
Correlation between Hepatitis B Viral Load and Liver Function Test among Hepatitis B Virus Patients in Khartoum State, Sudan
Hepatitis B virus (HBV) infection is a global public health problem. Sudan is classified among the countries with high hepatitis B virus seroprevalence . The purpose of this study was to study the correlation between the hepatitis B viral load and the liver function test in hepatitis BV patients Descriptive cross-sectional hospital based study conducted at the hepatology clinic Ibn Sinaa teaching hospital, covering all the patients who presented to the clinic from March-April 2018, primary data was collected from the patients and/or their care giver, a specifically designed questionnaire was used, and then the data was re-entered into a predesigned data collection form. A P value of 0.05 or less was considered statistically significant. The Data was analyzed using Social Package Statistical Analysis version (24). A total of 83 patients, 19 (22.9%) have viral load level less than 20 IU\ml, 33(39.8%) have viral ranging between (20-2000IU\ ML ), 13 (15.6%)have viral load between (2000-20,000IU\ML ) and 18(21.7%)have viral load more than 20,000IU\ML ) . The study showed a significant correlation between hepatitis B viral load and alanine aminotransferase level (ALT) with a P value of 0.027. The study showed a significant correlation between hepatitis B viral load and aspartate aminotransferase level (AST) with a P value of 0.009 .The study also showed there was a significant relation between hepatitis B viral load and serum albumin level with a P value of 0.007. Hepatitis B viral load was not affected by the age, gender or the duration of the disease. The liver function tests is recommended to be used as an indicator for the hepatitis B viral load and the degree of liver inflammation.
Cesarean Scar Ectopic Pregnancy: Experience From Benghazi Medical Center, 2022
Background: Cesarean scar pregnancy (CSP) is a rare consequence of a previous cesarean delivery and a new type of ectopic pregnancy, but it is life-threatening if unrecognized and inadequately managed. Despite the rising incidence of CSP, there are no consensus or evidence-based guidelines for management. Aims: To review risk factors, clinical features, diagnostic methods, and management of women with CSP at Benghazi Medical Center. Materials and methods: A descriptive-case series study of CSP cases between the Ist of March 2018 and Ist of April 2022.. Data collected retrospectively. The data included demographics, presenting symptoms and signs, ultrasound findings, treatment used, and any complications. Results: The total number of ectopic pregnancies in period between 1st March 2018 and 1st April 2022 was 262, ten women (3.82%) were diagnosed as scar ectopic, The women's ages ranged from 28 to 47 years, about 60% had three or four previous cesarean scars, abdominal pain with vaginal bleeding was in 30% of the cases, while 60% of patients were asymptomatic and all patients were stable during the diagnosis, except for one case that had signs of shock. ultrasound finding was 80% presence of gestational sac implanted low near the previous scar; initial diagnosis was delayed by 50%. The management was laparotomy and gestational sac excision in four cases that did not require further treatment, dilatation and uterine evacuation were done in two cases that required use of uterine balloon to control bleeding and further use of methotrexate In one case (10%), systemic methotrexate alone was effective. Severe bleeding was seen among 60% of women, and 20% underwent hysterectomy. The complications were significantly (P< 0.05) more common among women with high parity and also in cases where there was no intervention during the diagnosis. Conclusion: A previous uterine scar is the main risk factor for CSP; there is no specific clinical feature for CSP; ultrasound is used for the diagnosis; surgical management appears to be a better option, serious complications were seen mainly when no intervention was done during the diagnosis.
Prevalence of impacted canine among Libyan native’s orthodontic patients in Sirte city
This retrospective study was carried out in a dental center in the Sirte, a city in the middle region of Libya. Based on the surveying of panoramic radiographs of patients attended the dental clinic. A total of 500 panoramic radiographs were screened, and all patients with impacted canines were further screened clinically and radiologically. The purpose of this study was to report the prevalence of impacted canine teeth in Sirte city according to the age, and gender. The clinician can investigate the presence and position of the canine using visual inspection, palpation, and radiography. Canine impaction with or without other impactions occurred in (6.8%) of the scanned radiographs, with higher incidence in female (79.4%) than male (20.6%) cases. The aim of the present study was to create baseline information by evaluating the prevalence of impacted canine in middle region of Libya/Sirte city.
Influence of preoperative factors on the outcome of root canal treatment (Part 1): A retrospective clinical study
Aim: The aim of this study was to evaluate the effect of preoperative prognostic variables (Gender, Age, General medical health, Tooth type, Tooth location, Pulpal and periapical status) on the outcome of the initial endodontic therapy. Material and methods: Ninety-one patients out of 109 were included and had complete medical and dental record. A total of 146 teeth received an endodontic treatment and overall 408 Canals obturated. All treatments were performed through 2018 and 2019, in a private Dental Clinic in Sirte, Libya. Two independent endodontists, who have analyzed all preoperative and postoperative radiographs. Treatment effectiveness was evaluated using the European Society of Endodontology's standards. The periapical index was used to grade the periapical state. Setting the level of significance at p ˂ 5% by applying chisquare Pearson test. Results: The initial root canal procedure had an overall success rate of 89.7%. The health status showed their power effect on success rate with 83.6% (p-value =0.0001). Periapical status had a strong effect on the outcome. Apical periodontitis (AP) was existing in 49 of all teeth, with a PAI >3 in 17 teeth. The success rate (SR) was 61.6%, 11.6%, 6.8% & 9.7% with teeth has PAI 1, PAI 2, PAI 3 and PAI >3, respectively (p-value = 0.004). However, pulpal status shows that the success rate for vital teeth was 57.5% and for nonvital teeth was 32.2%.Conclusion: Within the parameters of the investigation, medical health and periapical condition have demonstrated to be powerful significant outcome predictors
Prevalence of urinary tract infection among HIV patients attending the infectious disease hospital in Benghazi, Libya
People living with Human Immunodeficiency Virus (HIV) are prone to opportunistic infections including urinary tract infection (UTI). There is limited evidence in Libya regarding UTIs and HIV. This study was conducted to determine the prevalence of UTI among HIV patients attending the infectious disease hospital in Benghazi, Libya. Urine samples are collected and processed by macroscopic and microscopic examination for the identification of bacteria. Antibiotic susceptibility testing was performed using Kirby-Bauer’s disc diffusion method. Urine samples were collected from 112 HIV seropositive patients, and 428 seronegative control group individuals. Out of 112 seropositive patients, 18(16%) had UTI. Escherichia coli was the most frequently occurring bacterial isolate 8(44%), followed by Staphylococcus aureus 4(21%), and Klebsiella species 3(17%). While the least common pathogens were Salmonella Species, Micrococcus, and Sphingo-bacterium; each had 1(6%). The age group 23-28 years recorded the highest prevalence of UTIs 11 (61%), while those aged 35-42 years had the least occurrence 2 (11%). On the other hand, out of 428 seronegative individuals' samples, 40(9%) yielded growth of bacteria. The distribution of uro-pathogens from urine specimens of seronegative patients revealed also Escherichia coli as the most prevalent uro-pathogens 18(45%), followed by Klebsiella species 8(20%) and then Staphylococcus aureus and Enterobacter species; each 5(12.5%). While the least common pathogens were Pseudomonas species and Staphylococcus Saprophyticus 2(5%). The age group 25-30 years recorded the highest prevalence of UTI; 11 (61%) in HIV-positive patients, while the age group. 41-70 years recorded the highest prevalence of UTI 18(45%) in HIV-negative patients. Female individuals showed the highest number of bacterial isolates; females had a prevalence of 14(78%) and males 4(22%) in seropositive patients, while in the seronegative patients, females had 35(87.5%) and males had 5(12.5). The study showed a high prevalence of UTIs among HIV patients which is an indication of the ineffectiveness of prophylaxis administered to HIV patients to prevent opportunistic
Urinary tract infection among HIV patients
Benghazi Center for Infection Disease & Immunity
Common Eye Diseases in children attending Makkah eye hospital in Aden, Yemen
Background: Eye diseases in children are important cause of medical consultation. This study aimed to determine the distribution and spectrum of childhood eye diseases at the pediatric outpatient clinics of Makkah eye hospital in Aden. Materials and method:This is an observational retrospective study. The medical records of all patients aged 16 years or younger who were seen at the pediatric ophthalmology outpatient clinics during the year 2021, were reviewed. The following data were recorded for each patient: sex, age, residency, site of trauma, site of disease, and diagnosis. Descriptive statistics were computed for continuous and categorical variables. The statistics computed included mean and standard deviations (SD) of continuous variables and are presented as mean ± SD, frequencies and percentages of categorical factors. Results: Total study patients were 146 (males were 61.6% and females were 38.4%). Most of them 58.2% were from rural areas. Their age ranged between 1 month to 16 years and their mean age was 7.1 ± 4.1 years. Children aged ≤ 5 years were (37.7%), of the age group 6 – 10 years were (35.6%) and of the age group 11 and 16 years were (26.7%). The most common eye disorders were ocular trauma in (43.2%) children. Squint was the second commonest disease and accounted (14.4%). Congenital glaucoma found in (11.6%) children, refractive error found in (9.6%) patients, and congenital cataract in (6.9%) children. Ocular trauma was predominant (19.9%) in the age group 6-10 years, while squint was predominant (6.8%) in the age group 10-16 years old and congenital glaucoma was predominant (10.2%) in the age group ≤ 5years. The highest frequency of refractive errors were found in children aged between 6 to 10 years and children aged between 11 to 16 years, (P = 0.000). Conclusion: The most common eye diseases in our study were ocular injuries, squint, congenital glaucoma, refractive errors and congenital cataract, respectively.
Clinical pattern of psoriasis in patients seen at our private clinic, in Aden, Yemen
Background: Psoriasis is a chronic immune-mediated systemic disease that is influenced by genetic and environmental factors. Objective: To presents the demographic characteristics, and clinical variants of psoriatic patients. Materials and methods: Present work was a retrospective and observational study, conducted in patients of a private clinic of dermatology, in Almansoora, Aden, Yemen. All patients who attended the clinic during the period January 2018 to December 2021 and were diagnosed as psoriasis patients were included in this study. Data were collected and entered in a computer, and analyzed by using SPSS version 17. Results: The study patients were 168. They were (57.1%) males and (42.9%) females, with a male-to-female ratio of 1.3:1. The age of the patients ranged between 10 to 58 years. The mean age of the patients was 38.2 ± 12.6 years. The age group 41 – 50 had the highest number of patients 54 (32.1%), followed by the age group 31 – 40 years 40 (23.8%) years. The mean duration since the onset of the disease is 6.1 ± 4.6 years. The most common psoriasis type was plaque psoriasis (vulgaris) (65.4%). Family history related to psoriasis was positive among (20.2%) patients. Diabetes mellitus and hypertriglyceridemia were found equally among the study patients, each one in (9.5%) and arterial hypertension was found in (7.2%) patients. The involvement of nails was observed in (31%) of patients and Koebner phenomena was found in (23.8%) of patients. Conclusion: Psoriasis is predominant in male patients, with a male-to-female ratio of 1.3:1, and the most common psoriasis type was plaque psoriasis.
Burr-hole versus Mini-craniotomy and (fenestration) membranectomy in management of membranous forming CSDH - Sirte experience
Objective: The best way to treat (membranous forming) chronic subdural hematoma is unknown. Thus, the purpose of this study was to compare single burr-hole drainage with mini-craniotomy in the treatment of (membrane forming) chronic subdural hematoma, taking into account complication and recurrence rates. Method: (7) patients with (membrane forming) CSDH who underwent surgery between January 2018 and June 2022 had their clinical and radiologic records extracted. They account for 2,5% of all CSDH patients (18) treated during the same time period. The cases undergoing various types of surgery were compared in terms of clinical and radiological outcomes. Result: These (7) patients were divided into two groups: group A (4) patients underwent a single burr-hole trepanation, (3) patients underwent mini-craniotomy and (fenestration) membraneotomy, during all procedures, subdural drainage was placed and removed three days later. All patients recovered completely, with only one case in group A having a rest subdural collection and no complications in group B .Conclusion: When compared to burr-hole evacuation, the mini-craniotomy with (fenestration) membraneotomy technique may be superior for the treatment of (membranous forming) CSDH. More subdural space visibility is made possible by the mini-craniotomy, which also enables more aggressive fluid evacuation, better irrigation of the area, the safe fenestration of any membranes that are accessible. Despite the evident limitations of this study, an upcoming effort to evaluate this technique may be merited
Clinical and pathological factors predictive of response to neoadjuvant chemotherapy in Locally Advanced breast cancer
This study was performed to examine the predictive factors of pathologic complete response (pCR) in locally advanced breast cancer (LABC) patients after neoadjuvant chemotherapy (NAC). LABC remains a clinical challenge, as distant metastasis develops in most patients, and they will experience disease relapse and eventual death. The identification of reliable predictive factors for neoadjuvant chemotherapy in LABC would help select those patients most likely to benefit from neoadjuvant chemotherapy. 84 LABC Egyptian patients with neoadjuvant therapy regimens containing 3-6 cycles of anthracyclin-based chemotherapy, followed by modified radical mastectomy (MRM) and node dissections, followed by adjuvant hormonal therapy and Radiotherapy.The patients were divided into two groups: pathological complete response (pCR) or non-pCR group. Clinico-pathological characteristics were compared and analyzed, and multivariate analyses were performed to detect the predictive factors of pCR. The pCR rate in both the breast and axilla was (8.33%), and 91.67% of the patients showed partial response. Multivariate logistic regression demonstrated that pCR was significantly associated with The absence of nodal metastasis, necrosis, lymphovascular invasion and carcinoma in situ and negative ER , PR and HER2 and the non-triple negative tumours. the absence of tumor necrosis, DCIS and LVI and negative hormonal status on initial core biopsy are linked to achieving pCR
Camptodactyly is a congenital deformity characterized by a flexed posture in the proximal interphalangeal joint. It is generally found in the little finger and may or may not include the other fingers. It is painless and nontraumatic [1]. It affects approximately 1% of the population. It is bilateral in around two thirds of the patients, although the degree of contracture is usually not symmetrical [2]. The deformity generally increases during growth spurts, especially during the periods of rapid growth from one to four years and from 10 to 14 years of age [3]. The primary cause of this deformity is still a matter for discussion and there is no consensus in the worldwide literature. Although some cases occur sporadically, there is often an autosomal inheritance pattern present. The metacarpophalangeal and distal interphalangeal joints are unaffected, although they may develop compensatory deformities [4]. The purpose of this study is to assess the clinical result of surgical treatment in management of camptadoctyly and to evaluate the results by clinical assessment. This retrospective study was carried out on fifteen patients. These patients with flexion deformity were admitted in Upper Limb and Reconstructive Microsurgery Unite in Assiut University Hospital and were managed by surgical treatment. Age ranges from 2to 15 year, the mean age intervention was 9.8 years. There were 9 males and 6 females as males 60% to 40% females, there were 4 cases with positive family history and 11 case with negative family history. And 4 cases with excellent result, 4 cases good ,7 cases with fair ,17 cases with poor result. From this study the best time to operative at age between (1.5-2.5) years. Also need more family knowledge about camptodactyly to start treatment early
flexor digitorum superficial is tenotomy.
Prevalence of Diabetes and Hypertension amongst patients admitted with Acute Myocardial Infarction to Ibn-Sina Teaching Hospital
Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide. Acute Myocardial Infarction (AMI) is the most common form of CHD and is responsible for over 15% of mortality every year. Hypertension (HTN) and diabetes mellitus (DM) are thought to be the most significant risk factors for developing CHD. Old age is a risk factor in both genders. However, Younger female are less likely to be affected compared to males. This study aims to assess the prevalence of HTN, DM, or both amongst patients admitted with acute MI (AMI) and to demonstrate the distribution of AMI according to age group and gender. Comorbidity data from 36 patients (22 males and 14 females) admitted with AMI to Ibn-Sina hospital between January 2018 and December 2018 was analyzed, tabulated, and graphed using Microsoft Excel.Our results showed that 8 patients (22.2%) had HTN prior to admission and 6 patients (16.6%) had DM, whilst 16 patients (44.4%) had both HTN and DM. 6 patients (16.6%) had neither HTN or DM. Male patients had the highest incidence of AMIs (22 patients, 62.5%). Furthermore, the highest incidence of AMIs in male patients were in the ‘40-59’ age group, as compared with the female group with the highest incidence of AMIs being in the ‘60-69’ age group. A combined co-morbidity of HTN and DM was shown to be a high-risk factor for the incidence of MI. Furthermore, MI incidence was shown to be higher in the male population, and presents at a younger age in males than females.
Mesenteric Cyst Lymphangiomas in 6 years Old Boy (A Case Report)
mesenteric cyst lymphangioma is a rare benign intra-abdominal tumour, It is located in the mesentery of the gastrointestinal tract and may extend from the base of the mesentery into the retroperitoneum. chylous ascites is an uncommon form of ascites due to leakage of lipid-rich lymph into the peritoneal cavity, it is diagnosed by the presence of milky-appearing ascites fluid and white triglyceride content >200mg/dl. We report 6-year-old boy presented progressive Vega abdominal pain over one month associated lately with abdominal distention and vomiting, abdominal ultrasound and NON-CONTRAST computed tomography (CT) revealed a large cystic abdominal lesion demonstrating multiple septations involving the retroperitoneal region. The intra-operative finding was a large yellowish septate mesenteric cyst arising from both mesenteric borders of jejunal loop extending retroperitoneal with white mesentery and multiple reactionary lymph node and chylous acites.