Prevalence of diabetic retinopathy and associated risk factors in diabetic type II patients in Ajdabiya, Libya

Diabetic retinopathy (DR) is One of the most wellknown microvascular complications of diabetes mellitus (DM) and is a frequent side effect of untreated diabetes that can lead to blindness and visual impairment. This study was conducted to assess the prevalence of diabetic retinopathy and associated factors among type 2 diabetic patients. A cross sectional study was done at Ajdabiya diabetic center from November 2023 to January 2024. Subjects and Methods: 52 patients (104 eyes) with T2DM were included in this study, their fasting blood sugar and glycosylated hemoglobin level, lipid profile measured.in addition to fundus examination (done by noncontact +90-diopter lens), fundus photographs taken by Non-Mydriatic Fundus Camera TFC-1000. Around 61 eyes (58.7%) had diabetic retinopathy, 27 eyes (26%) had back ground DR, 6 eyes (5.8 %) had pre-proliferative DR, 4 eyes (3.8%) had proliferative DR, 2 eyes (1.9%) had advanced diabetic eye disease, 22 eyes (21.2%) had CSME. Their ages ranges between 36­74 years with mean (58.90) years, (26.9%) were males, (73.1%) were females. There was a significant association between the development of DR and duration of DM (p=0.003), The FBS levels were also determined to be a significant risk factor for DR (p = 0.031), also LDL with (p=0.039). No other factors were found to have a significant association with DR. In this study more than half of diabetic patients had diabetic retinopathy. There was a significant association between the development of DR and duration of DM, FBS, LDL levels, there was no significant relation between diabetic retinopathy and hypertension, HgA1c Serum cholesterol or triglyceride levels or previous cataract surgery.

Evaluation of maternal and perinatal outcomes in pregnancy with preeclampsia at Aljala Maternity Hospital

Hypertensive disorders of pregnancy (HDP) accounts for 18% of maternal deaths worldwide, with an estimated number of about 62, 000­77, 000 deaths occur each year. The current study aimed to assess maternal and perinatal outcomes of pregnancies complicated by hypertension in Aljala Maternity Hospital. A retrospective, descriptive, case series analysis for four hundred patients was done on the outcome of hypertensive disorder among pregnant women who admitted and were managed at Aljala teaching hospital with preeclampsia during the years 2019 and 2020. Demographic data involving age, parity, gestational week, clinical and laboratory findings were recorded from the medical files. Additionally, delivery route, indications of cesarean section, fetal and maternal complications were determined. The current finding reported high prevalence of perinatal and maternal mortality among pregnant women with preeclampsia. Moreover, other severe maternal and perinatal complications such as Hemolysis Elevated Liver Enzyme Platelet (HELLP) syndrome, placental abruption, eclamptic fits, as well as low birth weight were also commonly reported. The current study showed early onset of preeclampsia was associated with increased risk of developing adverse maternal-fetal/neonatal outcomes compared to lateonset after 36 weeks. Our findings call for special consideration and close surveillance of those women with early-onset diseases

Preliminary study of vitamin D deficiency and its associated risk factors in Libya

This study was conducted to investigate levels among the target population and its associated risk factors in Libya. A cross-sectional study was conducted to investigate level and its associated risk factors in Libya during 2022-2023. 192 serum samples were tested in private laboratories. A structured designated questionnaire was filled in containing all the relevant information. Descriptive analyses frequency and percent were measured for numerical data, number, and percent for qualitative data using SPSS version 22. The chi-square test and student t-test were used for the data analysis and to investigate the level of association among variables at the significance level of (p=0.894) The results showed that using supplements for hypovitaminosis did not significantly influence therapeutic outcomes. The mean average level among males was significantly higher than those in females; however, both levels in the two groups are in the deficiency category. Interestingly the group who received treatment of vitamin D, their level was lower than the group who did not receive treatment

Predictors of Asthma Control among Libyan Adolescents with Persistent Asthma

@#Introduction: Among adolescents, asthma is an important public health burden that is associated with high morbidity and mortality. Poor asthma control is likely in this age group. Our aim was to identify the predictors of well controlled asthma among adolescents with persistent asthma in Northwest of Libya. Methods: A sample of 92 adolescents with persistent asthma were recruited from the respiratory clinic in Sabratha Teaching Hospital, and completed questionnaires measuring demographic and clinical characteristics, asthma knowledge, self-efficacy, and asthma control. Logistic regression analysis was carried out, taking the asthma control as the dependent variable. Results: Twenty-four percent of participants had well controlled asthma. In a bivariate analysis, well controlled asthma was significantly associated with adolescents having mild persistent asthma, not having allergic rhinitis, using preventive inhalers regularly, reporting higher level asthma knowledge, and higher self-efficacy. However, in multiple logistic model, only self-efficacy was an independent predictor of asthma control, with higher self-efficacy associated with well-controlled asthma (Adjusted OR= 1.107, 95% CI: 1.012 – 1.210, p= 0.026). Conclusion: Identifying and targeting modifiable predictors of well controlled asthma could improve asthma control. In adolescents with asthma, enhancing self-confidence of adolescents to undertake health behaviour modification seems to be an important step toward a better asthma control.

A Morphopathological Study on Ovine Pulmonary Adenocarcinoma in Libya

Aims: To determine a first estimate of the prevalence of Ovine Pulmonary Adenocarcinoma (OPA) in slaughtered sheep in East of Libya and to investigate morphopathological characteristics of OPA forms in native sheep of Libya. Study Design: This study was carried out in some El-Beida slaughterhouses (in an eastern part of Libya) during the period from October 2020 to April 2021. Methods: The animal involved in this study was native sheep of more than 4 months age. Lungs of 525 sheep carcasses were examined then full sections (n= 141) were used for histopathological examination. Results: OPA was detected in 1.1% of all examined cases and in 2.97% of affected lungs. 4 out of 6 sheep, showed the classical form whereas atypical lesions were detected in 2 out of 6 sheep. Histopathological changes were almost similar in the two forms of the disease. Conclusion: OPA is well documented for the first time in sheep from El-Beida area and classical and atypical forms of OPA were reported and described. Moreover, this study provides a morphological background necessary for routine differentiation and indicates the necessity for initiating further studies on identifying the epidemiology, etiological agents and pathogenesis of OPA in Libyan sheep

Seroprevalence study of Toscana virus in Yafran area, Libya

Background & objectives: In Mediterranean countries, infection of Toscana virus is a public health problem during the summer season, related to sandflies activity; it may cause aseptic meningitis and mild meningoencephalitis. We investigated the presence of antibodies (IgG) against the Toscana virus in the sera of individuals living in the area of Yafran, Libya. Methods: During the period from December 2013 to February 2014, a total of 232 sera samples were collected from Yefran hospital. Demographic information of participants collected in a questionnaire; samples were analyzed by the serological method of enzyme-linked immunoassays specific for Toscana IgG antibodies. Results: Seroprevalence of IgG antibodies among samples was 25% (n = 232). Seroprevalence varied among genders, age groups. The differences were not statically significant. Interpretation & conclusion: Our findings indicate and confirm local circulation of the Toscana virus. It also indicates that TOSV infection is neglected, and needs to be considered as one of the causes of meningitis or meningoencephalitis.

Potential risk factors for mortality in patients with COVID-19: A retrospective study

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection caused more than five million deaths throughout the world and more than five thousand deaths in Libya, a little is known about the mortality rate and the risk factors for death from this serious infectious disease in Libya. Thus, it is aimed in this study to identify the potential risk factors for mortality from SARS-CoV-2 infections among 176 Libyan COVID-19 patients in Zawia city. This research is a retrospective cohort study that was conducted on 176 randomly selected volunteers who had been infected with SARS-CoV-2 during a period of December2020 to February 2021 in Zawia city, Libya. Following filling the prepared validated questionnaire by COVID-19 patients, the data was analyzed to determine the previously mentioned risk factors. The mean age(SD) of the total 176 participated COVID-19 patients was 45.06 (± 17.7) and the mortality rate among these total involved cases (mild to severe cases) was 10.8%. It is found that the mortality among the severe COVID19 cases was 41.3% and the mean age (SD) of COVID-19 deaths was 69.1 years (13.8) and 73.7% of them were 60 years old or older. In addition, it is found that 63.2% of the SARS-CoV-2 deaths were females and 78.9% of them had a positive history of chronic diseases. Moreover, it was found that the most common chronic diseases among COVID-19 deaths are diabetes mellitus and hypertension (73.3% and 53.3%, respectively). Collectively, it is concluded that COVID-19 elderly female patients aging 60 years or older with a positive history of chronic disease are more likely at high risk for death from SARS-CoV-2 infection among the participated COVID cases

Association of COVID-19 severity with vitamin D and blood group

Abstract: Vitamin D is a hormone which plays a vital role in immune response regulation, including the prevention of inflammation and autoimmunity. Insufficient vitamin D may increase the risk of infection. Vitamin D deficiency is not the only factor linked to an elevated risk of COVID-19 infection. Recent studies have discovered a link between SARS-COV-2 infection risk and blood type. This study was aimed to examine the association of vitamin D and blood groups with the severity of COVID-19. A retrospective study was conducted on 224 confirmed COVID-19 patients, aged between 18 and 89 years old. Patients were divided into three groups (asymptomatic, moderate, and severe cases), and serum 25(OH)D concentration and blood group were analyzed for all the patients. Data of the severe cases were obtained from Souq Althalath Isolation Center, Tripoli, Libya, while moderate and asymptomatic cases were obtained from Abushusha Polyclinic and Aldahmani COVID Filtration Center, during 22nd February 2021 and 28th April 2021 and serum 25(OH)D concentration and blood group were statistically analyzed for all the patients. The percentages of males andfemales were found to be 47.3% and 52.7%, respectively. Disease severity was distributed as follows: 12.5% asymptomatic, 44.6 % moderate and 42.9% severe. Most of the severe cases had vitamin D deficiency (88.5%). Among the severely ill patients, 39.6% had blood group A and 09.4% had group O, while 22.9%, and 28.1% had blood group B and AB, respectively. In contrast, among the asymptomatic patients, only 7.1% had group A and 85.7% had group O. Overall, the difference in the distribution pattern of blood group in the three severity categories was highly significant (p < 0.001). The prevalence of Rh positivity among asymptomatic, moderate and severe cases was 78.6%, 76.0%, and 60.4%, respectively. This study concludes that insufficient vitamin D levels might influence the severity of COVID-19. COVID-19 patients with blood group A and those who are Rh-positive could be more vulnerable to developing COVID-19 severity

Presentation and character for adult patients with diabetes in Libya

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient's demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Pharmaceutical situation of the pharmacological treatment of hospitalized patients with COVID-19 in Libya

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center's protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines' List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines' list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Hematological consequences of antiepileptic drug therapy among children with epilepsy

Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer's disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Prevalence of vitamin D deficiency in medical students

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142,72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals

Effect of occupational exposure on hematological and biochemical parameters in workers at oil and gas companies

Petroleum refineries are largest chemical industries that are responsible for emission of several pollutants into the atmosphere. Benzene and its metabolites are regarded as the most hazardous compounds that are emitted by petroleum refineries. These contribute to toxic oxidants, which cause many serious health risks to petroleum refineries workers. This study was aimed to analyze the effects of chemical exposure on hematological and biochemical parameters among workers at Zawia oil refinery and Mellituh oil and gas refinery companies. A total of 200 workers participated in this study which consisting of two equal groups (each group: n = 100). The first group consists of petroleum refineries workers and the second group consists of non-oil work civil servants serving were recruited as exposed and control subjects, respectively. The results of blood picture, liver enzymes and kidney functions were compared between the groups. Mean white blood cells counts, platelet counts, and hematocrit count were significantly higher, while the mean red blood cells count was insignificantly changed in petroleum refineries workers. While the mean hemoglobin and corpuscular hemoglobin concentration levels were significantly lower, whereas the mean corpuscular volume and mean corpuscular hemoglobin levels were insignificantly changed in petrol refineries workers. Liver enzymes and renal functions were significantly higher in petrol refineries workers. The present findings indicate that occupational exposure to benzene causes significant alterations in hematological and biochemical parameters and workers are at high risk of developing blood, hepatic or renal related disorders. Protection and frequent medical attention should be given to petroleum refineries workers.

La crisis en Libia y sus efectos en la región del Sahel / The crisis in Libya and its effects on the Sahel región / A crise em Líbia e os seus efeitos na região do Sahel

Resumen El siguiente artículo analiza desde la perspectiva clásica de seguridad la evolución de la política exterior de Libia durante la era de Muammar Gaddafi, caracterizándose en su inicio por ser una amenaza de guerra constante a transformarse en el principal factor de estabilidad de la región del Sahel antes de su caída. Desde este punto se examinan las consecuencias que, en materia de seguridad, acontecieron en la región tras la desaparición del líder libio y los factores de riesgo que aumentan la vulnerabilidad de esta, ante la situación caótica en el país norafricano, sumado a la intervención militar de Occidente en Libia, la cual profundiza la situación de violencia al no permitir la reconfiguración de una autoridad central fuerte.

Abstract The following article analyzes from the classical security perspective the evolution of Libya's foreign policy during the era of Muammar Gaddafi , characterized at the beginning as being a constant threat of war, to become the main stability factor of the Sahel region before his fall. From this point we examine the consequences that, in terms of security, occurred in the region following the demise of the Libyan leader and the risk factors that increase its vulnerability, given the chaotic situation in the North African country, added to the Western military intervention in Libya, which deepens the violence situation by not allowing the reconfi guration of a strong central authority.

Resumo O seguinte artigo analisa desde a perspectiva clássica de segurança a evolução da política exterior de Líbia durante a era de Muammar Gaddafi, caracterizar-se em seu início por ser una ameaça de guerra constante a se transformar no principal fator de estabilidade da região do Sahel antes da sua caída. Desde este ponto examinam-se as consequências que, em matéria de segurança, aconteceram na região após do desaparecimento do líder líbio e os fatores de risco que aumentam a vulnerabilidade desta, perante a situação caótica no país norte-africano, somado à intervenção militar de Ocidente em Líbia, a qual aprofunda a situação de violencia ao não permitir a reconfiguração de uma autoridade central forte.

PREVALENCE OF RECURRENT HEADACHE AMONG UNDERGRADUATE’S STUDENTS OF A FACULTY OF MEDICAL TECHNOLOGY IN DERNA CITY: A PILOT STUDY

Background: Headache is major common neurological disease. Headache is a worldwide health problem, and is one of most common reasons for patients to seek health advice. The aim of this to determine prevalence of recurrent headache, associated risk factors and cause of headache among students at faculty of medical technology in Derna city, Libya. Methods: This is a cross-sectional survey in faculty of medical technology, Derna, Libya using a self-administration questionnaire from March to May 2013 on sample of 150 students in the faculty of medical technology. A questionnaire was given to the students who were selected by systematic random sampling. Results: 150 questionnaires were distributed to undergraduate student in the faculty of medical technology, of which 95 were returned, giving a participation rate of 63.3%, mean age=21.2± 2.2 years. There were 40 (42.1%) males and 53 (55.8%) females. The prevalence of recurrent headache was estimated to be 72.6%(69/95). The higher prevalence of headache was in females. Headache was significantly common in females than in males (X2=17.9; P <0.001). Conclusion: The study shows high prevalence of recurrent headache among the students, which will affect the academic performance, and the life activities of the students. Provide entertainments services in the school are very important to reduce prevalence of headache among the students special during the exam period.

Congestive Heart Failure among the Libyan Population (North Africa); A Community Based Survey of Risk Factors and Complication.

Congestive Heart failure (CHF) is a very common medical disorder and a major health problem in Libya. CHF is associated with an increase in the risk of stroke and hospitalization. Objectives: To estimate and describe the main risk factors and complications of CHF among people with a particular interest in Libyan community. Methodology: This project is classified as a community based descriptive cross-sectional study using the CHADS2 questionnaire as well as the local Libyan classification called the Community Stroke Risk Classification (CSRC). Area; North Africa (North of Libya, the capital Tripoli). Time; five years from 2010-2014 Population: Convenient sampling was done from a large cohort of individuals living in the Libyan community. 7497 individuals were screened for risk factors of stroke. CHF was one such factor which was studied in detail among the sample population and was diagnosed by taking detailed histories (including treatment), medical examinations and previous hospital confirmations. Results: The prevalence of CHF among our participants (7497 individuals) was 15.2% (1139 patients) among the sample population as a total with males and females being 51.2% and 48.8% respectively (P=0.87). Among different age groups, females had higher rates than the males except for age interval from 60 to 79 where males had higher rates. The male to female ratio among the total population screened for CHF was 7.8%: 7.4% (583:556 respectively with males being higher). CHF prevalence increased with the progress of age, with higher rates among age groups of over 40 (P <0.0001). 68.3% of CHF patients had hypertension (778 patients), 54.3% had DM (618 patients), 38.7% had transient ischemic attach (TIA) (441 patients), 27.2% had atrial fibrillation (AF) (310 patients), 25.9% had prior stroke (PS) (295 patients), All of these risk factors accompanying CHF increased with age (P<0.0001). 99.92% of CHF patients had risk points of stroke in CHADS2 scores (0.08% had no risk points), from whom 27.1% had intermediate scores (1-2 Risk Points) and 72.9% had high scores (≥3 risk points) (P<0.0001). Results of the CSRC scores showed that 99.91% had risk factors of stroke (0.09% had no risk factors), from whom 29.5% had intermediate scores (1-2 Risk Factors) and 70.5% had high scores (≥3 risk factors) (P<0.0001). Conclusion: CHF is a major risk factor of stroke among the Libyan population in North Africa of whom had very high CHADS2 risk scores. These scores are defined as a combination of six different risk points; 0 points being low risk, 1-2 being intermediate, and a score of 3 or more risk points is defined as being high risk. CHF appeared to dominate the high scores (≥3 risk points). Almost all CHF patients had risk factors of stroke on the CSRC scoring system of whom expressed intermediate and high scores with a significant proportion of high scores (≥3 risk factors of stroke). Hypertension, DM, AF and being aged of over 40 years were very important risk factors contributing to CHF. Both genders of male and female had similar chances of developing CHF in the Libyan community. CHADS2 & CSRC classification scores are very useful and simple tools to be used to classify and describe the risk factors of stroke in populations living within a community.

Role of Hypertension as a Major Risk Factor of Stroke in Africa; Libya: Community Based Survey.

Hypertension is a very common medical disorder and a major health problem in North Africa. Hypertension is associated with an increase in the risk of stroke and hospitalization. Objectives: To estimate the importance of hypertension (HT) as a stroke predisposing risk factor among people living in Libyan community using both CHADS2 and Community Stroke Risk Classification (CSRC). Methodology: Area; North Africa (North of Libya, the capital Tripoli). Time; Five years from 2010-2014. The study was a community based descriptive cross-section, which screened 7497 individuals living in local communities, looking for risk factors of stroke. Hypertension was one of the factors which was studied in details by community physicians, among this population whom have HT were diagnosed by their past histories, medical reports, hospital discharge letters, whether they were taking any treatment or on a diet for hypertension and also medical examinations were conducted to confirm diagnosis by measuring blood pressures. Results: The prevalence of HT among study participants (7497 individuals) was 38% (2850 patients), among males and females was 50.2% and 49.8% respectively (P =0.041). Among different age groups, males had higher rates than females except for age intervals of 50-59 and ≥80 where females had higher rates. The male to female ratio among the total population screened was almost similar (19%: 18.9%). HT prevalence rose with the increase of age, with higher rates among age groups of over 40 (P <0.0001). 53% of hypertensive patients had: Diabetes Mellitus (DM) (1538 patients), 27.3% had Congestive Heart Failure (CHF) (778 patients), 15.6% had Atrial Fibrillation (AF) (446 patients), 26.7% had Transient Ischemic attack (TIA) (761 patients), and 14.8% had prior stroke (PS) (423 patients), All these risk factors accompanying hypertension rose with increase of age (P<0.0001). 99.9% of hypertensive patients had risk points of stroke on the CHADS2 scoring system (0.1% had no risk points), from that 53% had intermediate scores (1-2 Risk Points) and 47% had high scores (≥3 risk points). Results of CSRC score showed that 99.9% of hypertensive patients had risk factors of stroke (0.1% had no risk factors), from whom 56% had intermediate scores (1-2 Risk Factors) and 54% had high scores (≥3 risk factors). Conclusion: Hypertension is a major risk factor of stroke among the North African Libyan population and many, of whom have HT, had very high risk scores in CHADS2 which mainly concentrates on 1-6 risk points (P<0.0001). Almost all hypertensive patients had risk factors of stroke on CSRC scores which was generally contributed to intermediate and high scores. CHADS2 & CSRC classification scores are very useful tools to be used to classify and describe the risk factors of stroke in a population of a community regardless of having hypertension or not.

Demographic and Pathological Characteristics of Thyroid Cancer in Libya.

Background: The study evaluates the prevalence and incidence of thyroid cancer in Libya, and describes demographic and clincopathological features. Patients and Methods: The study was conducted on 64 patients with thyroid carcinoma, admitted to the Misurata hospitals, Libya during the years 2000-2012. The clincopathological features were collected from pathology reports and hospital files of the patients. Results: The mean age of thyroid cancer patients in Libya was 46 years, which is much higher than in benign lesions (36.5 years). Libyan thyroid cancer prevalence and incidence was evaluated as 12.4 and 2.9 per 100,000 females, respectively. The histological types of the thyroid cancer in Libyan populations showed that the papillary carcinoma was the predominant type followed by follicular carcinoma. On other hand, the medullary carcinoma was less common than anaplastic carcinoma. Among Libyan patient the systemic involvement, LN involvement, non-papillary histological type of tumor, and tumor size larger than 4cms were strongly associated with poor survival. Although, the men patients had shorter life span than women did, this survival difference was not statistically significant. The histological types and histopathological risk features show similar importance in respect to survival as the data from European thyroid cancer. Conclusion: In Libya, the thyroid cancer incidence is low and more common in female than in male. Libyan thyroid cancer is dominantly seen in young adult and displays unfavorable features such as high histological grade and stage, large size, frequent lymph node involvement and systemic metastases.

Awareness of Libyan Students and Academic Staff Members of Nanotechnology.

At the present time, nanotechnology is involved in every aspect of scientific life and its applications are being integrated into the economy, industry, trade and medicine. The world will require a skilled work force of more than two million nanotechnologists by 2015. The rapid advance in all fields of nanotechnology has led to integrate nanotechnology courses in high schools, institutes and university curricula all over the world. However, nanotechnology has not as, yet been integrated within the Libyan curricula at any level. Thus, this study focuses and explores the awareness of the academic staff and students in Tripoli (Alfateh) University about nanotechnology and nanoscience. Moreover their readiness to integrate the basics and applications into Libyan education curricula. The results show that education level and work place have an effect on the knowledge of the participants on nanotechnology, where about 65% of PhD degree holders knew about nanotechnology and were keen to learn and integrate this technology in the education system. Around 40 % of the participants’ information about Nanotechnology were gained from the internet while only 17% had obtained information from their own readings. The majority of the participants (60%) supported the idea of introducing nanotechnology studies to the curricula at pre-graduate stage. However, 29% believed that it should be integrated only in postgraduate studies, and only a few of the participants (11.3%) advised that a continuing education program would be the proper way to study nanotechnology. This study showed that relatively little awareness about nanotechnology is seen among Libyan staff members and students. However, the majority of the participants have realized the importance of the field of nanotechnology and its application, and were eager to learn more about this advanced technology. Based on the preliminary study regarding the opinion and readiness of participants of the current study, it is believed that the integration of nanotechnology and nanosciences in Libyan curricula at different levels of education is an inevitable step to meet the very rapid advances in the field of nanotechnology and its applications.

Extraction, separation and identification of compounds from leaves of Solanum elaeagnifolium Cav. (Solanaceae).

Aim of the present study was to identify some phenolic compounds isolated from the dried powder leaves of Solanum Elaeagnifolium Cav. (Solanaceae family) collected from Benghazi area, Libya originally native in the Americas. The extraction was carried out with methanol at room temperature and treated by acidification (H2SO4, pH = 4) & basification (NH4OH, pH = 10). The compounds were separated by chromatographic method through a wet glass silica gel column and purification by medium pressure liquid chroma-tography (MPLC). The experiment yielded one novel compound named 2-(2-hydroxyphenoxy)-3,6,8-trihydroxy-4H-chromen-4-one [A3] and three previously known phenolic which were isolated for the first time from this plant under study (Quercetin [A1], Rutin [A2] & Mangiferin [A4]). The structures were determined using modern spectroscopic techniques (IR, EI-mass, 1H-NMR, 13C-NMR, APT, HMQC & COSY) using DMSO-d6 solvent in magnetic resonance application.