Prevalence and Risk Factors for low back pain among Nurses at Benghazi Medical Centre, Libya

Lower back pain (LBP) is recognized as a cause of morbidity in developed nations in different occupational situations. Health care workers (HCWs), in particular nurses, are especially vulne-rable to LBP. About 60­80% of the general people suffer from LBP at some time during their lives. However, there is not enough care about workplace health and safety problems facing the health care workforce in developing nations, such as Libya. Thus, this study aimed to find out the status of low back pain and factors affecting pain among the nurses in Benghazi Medical Centre (BMC), Libya. Cross-sectional study was conducted on BMC in 2018. The data was collected by a self-administered questionnaire. Chi-square was used to determine the association between associated risk factors and LBP prevalence (p<0.05). There is a high prevalence (79%) of low back pain among nurses in BMC. Individual and work-related factors were found as risk factors for LBP. In Libya, nurses are considered as a critical health and safety concern, as a result of the weakness of policies in healthcare organizations. Consequently, a proper no weight lifting policy should be considered. If not, proper manual lifting must be implemented.

An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

The role of the fissure morphology in caries prevalence of the first permanent molar in Libyan children.

Dental caries is one of the commonest of all dental diseases and is the main cause of loss of teeth in young people. It is a common belief that the high caries susceptibility of occlusal surfaces of posterior teeth is directly related to the morphology of the pits and fissures. Occlusal fissures are deep invaginations of enamel, they can be classified into V-type: Wide at the top and gradually narrowing towards the bottom U-type almost the same width from top to bottom. I-type an extremely narrow slit IK-type extremely narrow slit associated with large space at the bottom Y-type wide at the top and suddenly narrowing towards the bottom.

Comparison of the incidence of colour blindness between sections of Libyan and Indian populations.

Incidence of Red-Green colour blindness was studied in a Libyan population and was then compared with the same in two samples of Indian population. The incidence of the Red-Green colour defect was found to be 2.209% amongst the males and 0.0% amongst the females in the Libyan study. However, the incidence was only 1.841% amongst the ethnic Libyan males. This incidence was comparable with those reported from other African countries like Congo and Uganda. The incidence of Red-Green colour defect amongst the Indian males was found to be 2.295% while it was 0.840% amongst the Indian females.

Dexamethasone as an adjunctive treatment of bacterial meningitis.

This study was conducted on 77 Libyan infants and children aged month to 10 years with acute bacterial meningitis. Upon admission, the patients were divided randomly in two groups. Group I (38 patients) received ceftriaxone plus dexamethasone i.v. Group II (39 patients) received ceftriaxone alone. Both groups were compared for mean changes in CSF sugar, CSF protein and CSF polymorph count at 4th day of treatment. There was a significant difference between the two groups in CSF sugar and protein changes (P < 0.05) but not in CSF polymorph (P > 0.05). Both groups showed prompt clinical response and similar occurrence of acute complications, fatality rate and permanent neurological sequelae. However, group I manifested shorter duration of fever (P < 0.05). Dexamethasone improved the inflammatory reaction in acute bacterial meningitis and shortened the duration of fever but it did not have any significant effect on the fatality and the occurrence of neurological sequelae of this disease.

Occlusal status and permanent teeth eruption in Libyan children.

The occlusal status was assessed in 2015 Libyan children. Angle class I was found to be the predominant type (94.5%), overbite relationship in the majority (50.6%) were within the incisal third. The mean overjet measurements ranged from 2 mm. to 8 mm. Small proportion (13.4%) of the children examined were assessed to have a signs of crowding. Only 18.7% of the children were found to require orthodontic treatment. Eruption of permanent teeth was earlier in girls than in boys. The interval of rest between the mandibular lateral incisors and canines was 2.68 years for boys and 2.76 years for girls.

Prevalence of secondary complications in Libyan diabetic patients

Seventy two Libyan diabetic patients with type II diabetes were clinically examined for the presence of secondary complications. These patients were attending the outpatient clinic of the diabetes hospital, Tripoli, libya after overnight fasting. 39% of them have eye disorders [background or proliferative retinopathy with or without cataract], 26.4% have autonomic neuropathy, 19% have vescular complications [microangiopathy or peripheral vascular disease] and 3% have nephropathy. The mean levels of fasting plasma glucose, body mass index and heart rate of these patients were 234 +/- 10 mg/di,30.7 +/- 0.7 kg/m2 and 78 +/- 1.7 beats/minute respectively. 32 patients have heart rate higher than 75 beats/min while 7 patients have lower than 65 beats/min. it is suspected that autonomic neuropathy might be the cause for these changes in the heart rate. Duration of diabetes appears to play some role in the onset and and progression of diabetic secondary complications especially in obese patients with poor metabolic control. Nephropathy and proliferative retinopathy seem to develop in the advanced stages of the disease. The responders [those with fasting plasma glucose less than 200 mg/di and Hb A1 less than 10%] have significantly lower levels of serum triglycerides, blood urea, serum creatinine and higher rate of creatinine clearance as well as lower mean/BMI score when compared with the nonresponders [those with plasma glucose levels higher than 200 mg/dl and Hb A1 more than 10%]. However, the levels of serum cholesterol of birth groups were not significantly different

Diabetes mellitus in Libya: a retrospective study.

The records of the Diabetes Hospital, Tripoli, Libya for the years 1961-1983 were examined and the available particulars relating to 24,962 diabetic patients (12,486 males + 12,476 females) registered during this period were obtained. The highest number of male and female diabetic patients were in the age group 40-50 years and the highest number of obese diabetic patients also belong to this age group. There was a gradual increase in the number of diabetic patients visiting the Diabetes Hospital with the highest number in 1983. The increase has been both in the type I and type II patients. In 1983, 15% of the diabetic patients belong to type I diabetes. Family history of diabetes appears to be an important factor in the onset and manifestation of type II diabetes. Patients with diabetes in the family have a lower mean body mass index and fasting blood glucose level as compared with those of patients without known case of diabetes in the family. This may be due to greater alertness, early diagnosis of the disease and steps taken to control blood glucose levels and body weight in the case of patients with family history of diabetes.

Cytogenetic analysis of Down syndrome in Libya.

The frequency of Down syndrome in Libya was 1 in 516 live births. The mean age of Down mother was 35.62 years. Eighty two percent of the Down mothers were over 30 years of age as compared to 36% of the control Libyan mothers. As there was a greater percentage of late conceptions, the maternal age appears to be influential in the birth of Down syndrome in Libya. Cytogenetically 96% of the cases were that of trisomy 21. There was one case each of mosaic and 21/21 translocation, and four cases of 14/21 translocation as evidenced by Giemsa banding. Twenty two percent of the cases of Down syndrome also had other associated congenital abnormalities. The unique features involved in genetic counselling in this population are discussed. This study reflects the enormous problem of Down syndrome in the Arab world.