Background: Hematuria is common complaint brings patients to a physician. Macroscopic hematuria can be transient or persistent, and it may or may not associate with significant urinary system abnormalities. Objective: The objective of this study is to determine the major causes of macroscopic hematuria in ages less 20 years. Patients and Method: Descriptive case series study carrried out as a collaborative study in Tripoli during Januray 2013 - December 2014. Patients who presented with macroscopic hematuria file were studied retrospectively for gender, age, possible associated diseases as glomerulalar diseases, urinary tract infection (UTI), and others. Results: Out of 126 patients had macroscopic hematuria, 107 patients had the required data that achieved the study protocol. They were 72 cases (67.28%) males and 35 cases (32.71%), and their age ranged between (7 and 20 years). Macroscopic hematuria was more frequently reported at the age 7–13 years, and it was reported in (58.87%) due to the glomerular lesion, and in (41.12%) due to nonglomerular cause. Acute poststreptococcal glomerulonephritis (AGN) was the most common cause of macroscopic hematuria (53.27%), UTI was the second cause of macroscopic hematuria (28.97%), and renal stone was (9.34%) of total causes. Macroscopic hematuria due to trauma reported in 3 cases (6.8%), and in 5 cases (2.27%) due to IgA nephropathy. Conclusion: AGN and UTI are common causes of macroscopic hematuria. Urine microscopic examination is essential to differentiate between them before preceding to the other complicated, expensive, and invasive investigations.

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Background: Peptic ulcer is a gastrointestinal disease characterized by mucosal damage. The study is aimed at evaluating the gastroprotective effect of Nigella sativa seed extract in rats. Materials and Methods: Twenty rats were divided into four groups of five rats each and were fasted for 18 h. Rats in Groups 1, 2, 3, and 4 were pretreated with normal saline, gestid, and N. sativa extract at 320 mg/kg and 640 mg/kg, respectively, 30 min before administration of 80% ethanol. All the rats were sacrificed after 1 h and the stomachs were cut open. The stomachs were examined for macroscopic lesions and processed for light microscopic study. Results: There was a significant decrease in ulcer index of rats pretreated with gestid suspension, 320 and 640 mg/kg of N. sativa extract as compared to those of rats pretreated with normal saline at P < 0.05. The stomach of rats pretreated with normal saline showed mucosa full of lesions, those of rats pretreated with gestid suspension showed very few vascular congestion, while those of rats pretreated with 640 mg/kg of N. sativa showed few vascular congestion. Photomicrograph of the stomach of rats pretreated with normal saline showed vacuolation of basement epithelium while those of rats pretreated with gestid suspension and N. sativa extract showed normal basement epithelium. Conclusion: N. sativa seed extract was able to protect the stomach mucosa from gastric ulceration.

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The incidence of ductal carcinoma in situ (DCIS) of the breast has greatly increased in countries with breast cancer early detection programs. However, uncertainty remains about its natural history and precise implication of its diagnosis with growing concern in some quarters about possible overdiagnosis and overtreatment. Various molecular techniques have been applied to the investigation of DCIS in an attempt to clarify its biology in relation to invasive breast cancer. The following is a historical tour of some of those molecular studies and the contributions they have made to our understanding of DCIS. It is preceded by a recap of the DCIS conundrum and the uncertainties surrounding its natural history. Peer-reviewed scientific publications on the subject were retrieved by search of PubMed databases. The search was conducted with the following string of keywords: “breast carcinoma in situ genetics,” “breast carcinoma in situ molecular biology,” and “ductal carcinoma in situ molecular method technique.” Reference lists of retrieved articles were scrutinized for additional, relevant publications.

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Background: Rotavirus causes a significant proportion of diarrheal disease among young children worldwide. However, there is limited knowledge about the epidemiology of rotavirus in Libya. This study aimed to quantify the burden of rotavirus diarrhea among children under age 5 years. Materials and Methods: A prospective cross-sectional study was conducted in Almarj city between January 2011 and March 2012. Stool samples were obtained and tested for rotavirus from children <5 years admitted to the main public hospital for diarrhea. Patients with rotavirus were characterized by clinical symptoms; duration of diarrhea, fever, vomiting, and dehydration. Analyses of positive rotavirus patients were further stratified by breastfed versus bottle-fed children. Results: Rotavirus accounted for 57.4% of 270 diarrhea cases admitted to Almarj hospital. Rotavirus cases were more likely to be younger than 1 year of age (74% in rotavirus positive). Rotavirus patients commonly had symptoms 6 days (65%), and presented with vomiting (69%), high fever was uncommon (13%), and 42% had a normal temperature. Dehydration was common; moderate dehydration was seen in 79% of patients and 12% were severely dehydrated. About 89% of children infected by rotavirus cases were fed by bottle. Conclusion: There is a high burden of rotavirus in Almerj city located in North-Eastern region of Libya. While breastfeeding is recommended to reduce risk; increasing coverage of the rotavirus vaccine in children is likely to be the most effective and cost-effective strategy.

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Context: The follow-up of differentiated thyroid cancer (DTC) after total thyroidectomy is commonly based on serum Tg determination, 131-iodine ((131)I) diagnostic whole-body scan (WBS) and neck ultrasound (n-US). Aims: Assess the frequency and risk factors for recurrence and persistent disease in patients with both undetectable serum Tg level and normal post ablation WBS at the time of ablation. Settings and Design: We conducted a retrospective study of 500 consecutive DTC patients, treated with I-131 between January 2000 and January 2009. Methods and Materials: Patients were treated in all cases with a 131-I activity. Serum Tg level was measured on the day of I-131 administration. A neck scintigraphy was performed in all patients. Statistical Analysis Used: It included a descriptive study with, for qualitative variables, a calculation of absolute and relative frequencies. Quantitative variables were expressed as averages, medians, and standard deviations with extreme values. Results: Among 500 patients ablated, 100 consecutive patients were included. The WBS was abnormal in 5 and n-US abnormal in 1. Among 95 patients with a normal WBS, Tg/TSH 6-18 months after ablation was undetectable. n-US was normal in 92 and falsely positive in 3. After a mean follow-up of 5 years, recurrence occurred in 2 cases, both with an aggressive histological variant. Conclusions: Our data suggest that the presence of undetectable levels of serum Tg/TSH at the time of the first control WBS after initial treatment, is highly predictive of complete and persistent remission. The control WBS has never given information that could influence the following therapeutic strategy. On this basis, we propose that the diagnostic (131) I WBS may be avoided in patients with undetectable levels of Tg/TSH in the absence of TgAb at the time of ablation.

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Background: Carbapenemase producing bacteria are a serious public health concern and further pressure on the last-resort antimicrobials. Objectives: The aim of the study was to investigate the molecular characteristics of 48 multi-resistant Enterobacteriaceae isolates recovered from clinical samples. Materials and Methods: Isolates were investigated by antimicrobial susceptibility testing and polymerase chain reaction protocols for bla_OXA-48and metallo-beta-lactamase genes. Results: Klebsiella pneumoniae and Escherichia coli isolates demonstrated high frequencies of multidrug resistance and various phenotypes. Eleven K. pneumoniae carried extended-spectrum β-lactamases genes of which four strains possessed both OXA-48 and New Delhi metallo genes. Conclusion: Carbapenemase-producing bacteria in the Libyan health system warrants further attention and are possibly underestimated. Urgent control and prevention actions are required.

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