ABSTRACT
A 29-year-old man with moderate coronavirus disease 2019 (COVID-19) pneumonia presented with a one-day history of palpitations. On examination, he was febrile and tachycardic (pulse rate of 182 beats per minute), with a blood pressure of 120/80 mmHg and oxygen saturation of 96%. Electrocardiography revealed sustained monomorphic wide-complex tachycardia. Carotid sinus massage and adenosine administration were ineffective. Although amiodarone administration slowed the heart rate and relieved his symptoms, sinus rhythm was not restored. We administered intravenous verapamil which terminated his arrhythmia. We diagnosed the patient with fascicular ventricular tachycardia (VT) with a right bundle branch block. He recovered from COVID-19 weeks later. The workup excluded all possible risk factors associated with VT except for COVID-19 infection.
ABSTRACT
BACKGROUND: Cancer incidence and cancer registries are essential for local epidemiological information. In Libya, scarce evidence exists with regard to incidence rates and distribution. AIM: To estimate cancer incidence in Libya and draw trends of cancer type distribution compared to regional and worldwide data. Such incidence data are needed to inform strategic decisions on cancer facilities, training, and research in the given geographical area of Misurata, the major city in the middle region and third largest in Libya. METHODS: This is an observational, multi-centre, city-wide study to account for all cancer cases. All radiology (computed tomography and magnetic resonance imaging) and pathology reports were examined across all public and private hospitals in and around Misurata. RESULTS: Four hundred and thirty cancer cases were identified to have been diagnosed during 12 months (July 2019-June 2020), yielding a cancer incidence of 71.7 per 100 000 population. Breast cancer (84, 19.5%), colorectal cancer (83, 19.3%), lung cancer (33, 7.7%), and prostate cancer (21, 4.9%) had the highest prevalence. CONCLUSION: Cancer incidence established in this study stands at 71.1, much lower than the worldwide reported incidence of 201.0. Several limitations lead to missing cancer cases from the survey period, mostly related to poor documentation, non-research friendly environment, and disorganised healthcare structure. Nevertheless, distribution by type represents a true contrast to the world cancer report. Finally, a national or regional inclusive cancer registry is essential to the flow of information that supports strategic planning and decision-making in developing cancer care in the country.
