Assessment of Knowledge towards Tuberculosis among general population in North East Libya.

The study aimed to evaluate the level of Tuberculosis (TB) related knowledge among general public in North East Libya. A cross sectional study was undertaken in 2009. A prevalidated questionnaire consisting of 23 items was sent to 1500 residents among five cities in North East Libya. In addition to the demographic details, the survey instrument was designed to collect information relating to transmission, diagnosis, risk factors, treatment and prevention of TB. Descriptive analysis was used to elaborate demographic information. Inferential statistics (Chi-square test and one-way ANOVA) were used whenever appropriate. P value of less than 0.05 was considered as significant. All data was analyzed using SPSS version 16.0. The overall knowledge towards TB among general population was measured as low. Mean knowledge score was 11.4±3.9 which was significantly higher among Libyans (11.7±3.8) than non Libyans (9.7±4.7, t=26.13) (P<0.001). In addition, respondents with tertiary education had significantly higher knowledge scores (11.8± 3.5) compared to those of intermediate (11.6± 4.4) and illiterate (7.7±5.5), [F=19.34, P=0.001]. This study reveals that knowledge towards TB within the population is poor. It is therefore suggested that specialized educational programs should be developed for community members to promote awareness towards TB.

MR imaging of cerebral and cerebellar hypervascularity associated with status epilepticus: case report.

A 20 year old male presented to the emergency department with generalized tonic clonic convulsions and up rolling of eye balls. He had history of seizure disorder for three years and on regular medical treatment and is compliant to medication. A non-contrast CT scan of the head was only done on 14th day of admission which showed hypodense areas in the right and left cerebellar hemisphere. MR imaging was performed four days later revealed high signal intensity in the both cerebellar hemispheres, both external capsules, both occipital and right parietal regions on fluid-attenuated inversion recovery (FLAIR). The post contrast MR imaging revealed diffuse cerebral and cerebellar hypervascularity in the similar region. This change of diffuse hypervascularity of both cerebral and cerebellar associated with seizure activity on post-contrast magnetic resonance imaging (MRI) has not been reported in any literature.

Hepatitis B vaccination status in health care workers of two university hospitals

Hepatitis B virus [HBV] infection is the leading cause of hepato-cellular carcinoma and acute liver failure in Asia. It usually transmits through parenteral routes. The health personnel are at high risk for acquiring HBV infection. This study was designed to determine the immunization status for HBV infection in healthcare workers [HCWs] of two university hospitals in Sindh, Pakistan. The healthcare workers of two university hospitals [Liaquat University Hospital, Jamshoro and Isra University Hospital, Hyderabad] were selected and divided into ten different groups. There were total 923 participants including 649 [70%] males and 274 [30%] females. The mean age of participants was 29.6 years. A total of 596 [64.6%] participants were immunized for HBV infection and 392 [66.2%] were inoculated three or more than three doses of vaccine. The pre vaccination HBSAg status was checked in 380 [41.2%] and it was positive in 18 [4.7%] participants. The frequency of immunization was highest in doctors [92.4%] and lowest in nursing assistants [18.9%]. A good number of HCWs is vaccinated against HBV infection in these two university hospitals of Sindh compared to general population of Pakistan. This study shows the need for a more aggressive approach to get HCWs vaccinated, because a significant percentage of them is not protected

Antituberculosis drug induced hepatitis

To study the incidence of drug induced hepatitis due to antituberculosis therapy. Descriptive study. Department of Internal medicine, Isra University Hospital Hyderabad, from January 2004 to December 2004. Medical records of all patients treated with antituberculosis therapy were ret rospectively reviewed. 215 patients were treated and 18 [8.4%] patients developed hepatitis. Rifctmpicin caused hepatitis in 2 [0.9%] patients. Isoniazid caused hepatitis in 11 [5.4%] cases. In 5 [2.3%] cases causative drug was unknown. In these cases, the patient died [four cases] or was lost to follow up [one case]. Among 215 treated cases, 4 patients [1.86%] died. Patients should be carefully monitored for the side effects of antituberculous sis chemotherapy

Urine protein electrophoresis of renal transplant recipients using room temperature precipitation technique.

Proteinuria is one of the markers of renal diseases. Its quantitative measurements alone limited diagnostic conclusions. To determine the extent of precipitated proteinuria as a tool for diagnosis, I used the precipitated urine protein without any effect of any chemical and heat for protein precipitation utilizing an approach which was developed previously (Ahmed Mukhtar, 1997 & 1998). Two samples of urine (5 c.c each) from two different occasions were collected from 8 renal transplant recipients with and 7 normal healthy persons without any history of renal involvement. The samples were dried at room temperature without adding any chemical for 24 hours and precipitated urine was diluted in 0.3-0.5 ml distilled water. Then were run on Bekman apparatus Paragon Electrophoresis System and scanned for electrophoresis bands for the following proteins in BDF hospital: albumin, alpha 1, alpha 2, beta, and gamma. The pattern of electrophoresis graph and bands were different in the urine of patients compared to the urine of healthy persons. There were alterations in alpha 1 and beta proteins in the urine of renal transplant recipients. This technique illustrates a feasible approach to estimate the protein alteration in renal transplant recipients, and this pilot study could be used as a tool for further studies.

Effect of PMA and IL-1 on matrix proteins with special reference to kidney mesangial cells.

Cytokines have different effects on the extracellular matrix proteins which were produced by a number of different cell lines. The extracellular matrix proteins fibronectin, collagen IV, vitronectin, laminin, proteoglycan, fetal proteoglycan and actin; and the cells human mesangial, BeWo, Hep G2 and BHK using APAAP and dot-blot assay were used. It was shown that IL-1 and PMA increased the staining intensity of proteoglycan, fibronectin and collagen IV and vitronectin and did not alter the intensity of staining. While PMA and IL-1 decreased but did not alter laminin, PMA increased the staining intensity of proteoglycan in mesangial cells but not altered in mesangial cells stimulated with IL-1. These results show that PMA and IL-1 altered the production and secretion of extracellular matrix proteins, these in turn could lead to the alteration of pore size, matrix properties and filtration of mesangial cells, and thus influence pathological conditions of renal diseases.

Diagnostic value of CT scan in paediatric neurological disorders

Computerised tomography [CT] is now an established and widely available neuroimaging technique. Data regarding 80 children undergoing CT scan at the Nishtar Hospital, Multan were analyzed. Indications for ordering a CT scan included complicated cases of meningitis, seizure disorders, developmental delay, cerebro-vascular lesions and children with suspected space occupying lesions [SOL]. CT scan provided significant help in diagnosis or management in 100% cases of acute hemiparesis and suspected SOL and in 80% cases of complicated meningitis. Diagnostic help was provided by CT in 66% of children with seizures and in 40% with developmental delay. However, in only a very small percentage of children with these disorders, scan findings helped in deciding the course of management. CT scan has been a very significant advance in cranial imaging, however, physicians need to carefully consider relevant clinical findings in children with neurological disorders before considering them a candidate for this costly investigation

Intestinal parasites in the state of Bahrain.

Intestinal parasites infections are common in the state of Bahrain, but the incidence is decreasing due to improvement in health and social standards. A community-based study sample of all population of Bahrain was done including all ages and nationalities. From 1st July 1984 to 28th February 1986, the first community-based study sample of all population of Bahrain was done including all ages and nationalities. A total number of 2123, about 0.006 of the population of 1981 census was chosen for the study. The study shown that 739 persons were infected with intestinal protozoa and helminths. The figure representing 34.8% of total sample size, whom 283 persons were symptomatic, about 38.3% of total infected sample size. Giardia lamblia and Trichuris trichuria were the most common parasites among the infected persons.

Giardiasis amongst in-and out-patients in Salmaniya Medical Centre in state of Bahrain.

Giardiasis is the most common protozoan parasite diagnosed in the pathology departments of Health Centres in the State of Bahrain. In 1983 all records of stool parasitology examinations in one of the largest medical centre (Salmaniya Medical Center) were studied, a total of 9664 records. The incidence of Giardia lamblia was 4% (386 cases) of the total records, about 21% of all infected persons by parasites. 100 persons from the above records were serologically examined by CIT with 93% positive results. The incidence of Giardia lamblia amongst the families of infected persons of the 386 cases was higher than the families of non-infected persons.

Monoclonal gammopathy, a three year study on paraproteinemias

Sera from 22 patients [16 males + 6 females] with electrophoretically and immunologically secured diagnosis of monoclonal gammopathy were tested for various biochemical parameters. The final clinical diagnosis showing gamma-globulinemias in them was in the order of multiple myeloma [MM] 20 nos, Waldenstrom macroglobulinemia [MW] 1 no. and light chain disease [LCD] 1 no. The incidence of plasma cell neoplasm among Saudies is not very rare. The predominant type is IgG myeloma [74%] with a kappa to lambda ratio of 2: 1. Bence Jones Proteinuria is comparativly less common. Elevated levels of gamma glutamyl transpeptidase [GGT] in a good number of patients indicate the high occurrence of hepatic involvement in such patients

three year study of the electrophoretic patterns of serum proteins with special reference to various globulinopathies in Saudis

Human sera comprising 545 specimens spread over a period of three years were analyzed electrophoretically for proteins. Only 159 samples [29%] exhibited abnormal serum protein patterns. They were in the order of inflammatory disorders [acute/chronic], 60 [37.7%], Polyclonal gammopathies,48 [30.1%], Cirrhosis, 22 [13.8%], Monoclonal gammopathies, 22 [13.8%], Agammaglobulinemia, 3 [1.9%], Nephrosis, 2 [1.2%], Protein-losing enteropathy, 1 [0.6%], Low-alpha 1 -antitrypsin, 1 [0.6%], Inflammatory diseases of various nature, therefore, constitute the major serum protein abnormalities in Riyadh. Moreover, their occurrence varies with age, sex and climatic conditions as elsewhere in the world

Ainhum: an unusual diseases of the toes

Ainhum is a peculiar process by which a toe, usually the fifth develops a fissure around its base which deepens gradually until the toe is auto-amputated. This is a rare condition seen primarily in the tropics, and Saudi Arabia is not one of the reported geographical locations for its occurrence. We report this case in a male Saudi, who had a mother with the same condition, and discuss the characteristics of this unusual disease