This paper presents an analysis of the available systematic reviews of educational, behavioral, and social interventions for children on the autism spectrum. Forty-six out of 1299 full-text articles were assessed against eligibility criteria, with a further 16 articles excluded for different reasons. The quality of the remaining 30 reviews was variable, and a further five were excluded due to low methodological quality. In the remaining 25 systematic reviews, none of the intervention types was found superior to the others, and there is generally weak evidence for the effectiveness of the reviewed interventions in improving autism-related impairments. Applicability of this evidence on children with severe autism is generally questionable. While there have been repeated calls for more large-scale studies, specifically randomized controlled trials, we conclude that the environments in which interventions typically take place are not conducive to this. Instead, researchers are advised to adopt sensitive, evidence-based approaches that work well with small sample groups.

Background: Vitamin D deficiency is common among patients with chronic kidney disease (CKD). The traditional supplementation of active Vitamin D (1,25–dihydroxyvitamin D (or 1-hydroxyvitamin D to CKD patients has been reported to control the level of secondary hyperparathyroidism but not sufficient to replenish the body store of Vitamin D (25-hydroxyvitamin D). Patients and Methods: We conducted a cross-sectional analysis of two major parameters, namely 25-hydroxyvitamin D and parathyroid hormone (PTH) levels, in 50 female and 30 male CKD patients, compared to a control group of 29 individuals. Aim: The aim of the study was to determine the prevalence of Vitamin D deficiency in different stages of Libyan CKD patients. Moreover, this study aimed to evaluate the prevalence of Vitamin D deficiency in those treated patients compared to untreated ones and also to compare the effect of Vitamin D treatment on Vitamin D and PTH levels. Results: The mean 25(OH) Vitamin D level in CKD patients was 18.45 (±13.6) ng/ml, whereas for the healthy control, it was 19.03 (±11.49) ng/ml. The level of 25(OH) Vitamin D <20 ng/ml was observed in 80.6% of untreated patients and hence classified as deficient, whereas only 69% of the involved healthy controls were found to be Vitamin D deficient. However, on treatment, the prevalence of Vitamin D deficiency in patients had declined to 30.8%. Furthermore, PTH level in Vitamin D-treated patients was 118.56 ± 38 pg/dl, while in untreated, it was 393.77 ± 46 pg/dl; this significant lowering effect on PTH level was not produced on treating patients with 1-hydroxyvitamin D alone, as the mean of PTH was 436.48 ± 62.55 pg/dl in the treated patients and 324.96 ± 67.61 pg/dl in untreated patients. Furthermore, no significant differences in the levels of 25(OH) Vitamin D were detected among patients who representing the different stages of CKD. Nevertheless, gender has no significant effect on 25(OH Vitamin D levels among tested patients (males, 15.34 ± 8.50 ng/ml and females, 16.42 ± 13.55 ng/ml). Conclusion: This study demonstrated significant low Vitamin D stores (low 25-hydroxyvitamin D) in CKD patients (80.6%), who did not receive supplemental doses of Vitamin D (ergocalciferol or cholecalciferol), which was not prevented by the use of microdoses (0.5–1μg/day) of 1-hydroxyvitamin D. Furthermore, there had been significant correlation between the Vitamin D-deficient CKD patients and higher levels of PTH levels. There had been no correlation between Vitamin D deficiency among the different stages of CKD, signifying that deficiency is amenable to correction with the supplemental doses of Vitamin D even in advanced CKD patients. This study, to our knowledge, represents the first biochemical analysis of 25-hydroxyvitamin D deficiency in Libyan CKD patients.

Background: Breast cancer in women is a major health burden in developed and developing countries. It is the second leading cause of death in women worldwide. Recently, the global cancer statistics indicate that breast cancer incidence is rising faster among women in developing countries. Aim: The aim of this study was to assess the knowledge, attitudes, and practice regarding breast cancer among female students at the College of Medical Technology Derna, Libya. Methods: This study was designed as a descriptive cross-sectional survey. A self-administered questionnaire was used to collect the information from the female students. Results: A total of 200 female students were used for the study. The ages of female students ranged from 18 to 27 with mean 20.8 ± 1.88 years. Some of the female students 28.5% (n = 57) had used correct practices of self-examination, 12.5% (n = 25) reported high knowledge of breast cancer and majority of them 90% (n = 180) have a good attitude about breast cancer. However, there was no significant association different between knowledge and practice and attitude and demographic factors. Conclusion: The study results showed insufficient knowledge of breast cancer among female students whereas they were in medical programs. Therefore, more educational programs could be designed to provide comprehensive information of breast cancer and breast self-examination to improve women's knowledge, which can help in the early detection of breast cancer for the better treatment.

Cystic, edematous, and myxoid lesions of the umbilical cord are rare conditions which have been sporadically reported in literature, most often detected at prenatal ultrasonography. Most reports of cystic cord conditions are ultrasonographic studies with a few featuring pathological descriptions. This is a report of a rare case of umbilical pseudocystic lesion with full pathological description. The possibility of this extremely myxoid lesion confounding the diagnosis of tumors such as angiomyxoma is highlighted.

As bariatric surgery is becoming a more sought-after treatment for morbid obesity, Wernicke's Encephalopathy (WE) is becoming more recognized complication of bariatric surgery. WE is a classic triad of symptoms of ataxia, ophthalmoplegia, and acute confusion due to thiamine deficiency. Bariatric surgery has its own complications in the form of vitamin deficiencies. Thiamine deficiency following bariatric surgery can present as WE. We present a case of 20-year-old young man, who presented after a short period of 3 months after sleeve gastrectomy with symptoms of diplopia and dizziness. The diagnosis was confirmed by the immediate resolution of the neurological symptoms after thiamine administration.

Chorea caused by gabapentin has been reported in the literature. Chorea is very distressing to patients and causes significant morbidity. We need to be aware that such a symptom can be directly caused by drugs such as gabapentin. This would prevent overinvestigating such cases and expedite patient recovery. In this study, we report a case of a young female who developed hemichorea shortly after taking a small dose of gabapentin for shoulder pain and resolved within a few days after discontinuing the drug. We have also performed a literature review of all cases of gabapentin-induced chorea.