Peritoneal tuberculosis (TB) remains a public health problem especially in the developing countries, even in the developed countries, where the disease had been mostly controlled; it poses a new challenge for health-care facilities as a result of increased immigration from high prevalence area, the use of more potent immunosuppressive therapy and the acquired immunodeficiency syndrome epidemic. The diagnosis of peritoneal TB is often challenging and cannot be made or excluded on the basis of clinical findings, which are quite protean and nonspecific. Blood biochemistry, complete blood cell count, and radiographic studies are of limited diagnostic value. Acid-fast smear of ascitic fluid has a low yield and cultures require weeks to give results and are positive in 2%–50% of diagnosed cases. Polymerase chain reaction analysis for rapid detection of bacillus tubercles in ascitic fluid has low yield, and the role of other biomarkers such as adenosine deaminase and gamma interferon is less well described and currently being evaluated as diagnostic tools. Laparoscopy with directed biopsy provides a rapid and correct diagnosis in 76%–100% of cases and should be performed early in suspected cases. Six-month therapy with the 4-drug regimen is effective in most of the patients, while the role of adjunctive corticosteroid therapy remains controversial.

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Background/Objectives: Hepatitis B virus (HBV) infection represents one of the most serious blood transfusion-transmitted viral infections. By implementation of the hepatitis B surface antigen (HBsAg) screening assay, blood banks in Libya have been considerably increased blood transfusion safety in term of protecting against the transmission of HBV infection. However, several studies demonstrated that donors who are HBsAg negative and hepatitis B core antibody (anti-HBc) positive maybe a potential source for posttransfusion hepatitis B. The aim of this study is to determine the presence of anti-HBc and HBV DNA (hepatitis B viral DNA) in healthy HBsAg-negative blood donors in eastern Libya (Tobruk region). Materials and Methods: A total of 500 serum samples were tested for HBsAg and obtained from healthy blood donors in blood bank unit in Tobruk Medical Center. All donors were tested for anti-HBc, using commercial ELISA and microwell methods (MBS-SRL, Milano, Italy). The reactive samples were further tested for the presence of HBV DNA using polymerase chain reaction (PCR). Results: In this study, the seroprevalence rate of anti-HBc sample was 54 (10.8%) among donors. The majority of anti-HBc-positive cases (52 of 54) were in the age group of 20–49 years. Of the 54 anti-HBc-positive samples, 4 (7.4%) were tested positive for HBV DNA by PCR. Conclusion: Among all the samples, the rate of anti-HBc was 10.8%. This finding is comparable to a previous study performed in northwestern Libya. The present study estimated the expected exclusion rate of anti-HBc-positive donated blood that would be an important factor to consider before adopting anti-HBc testing in addition to HBsAg testing as a mandatory screening test to further enhance transfusion safety.

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Background: Measles is a highly contagious virus. An effective vaccine has been widely administered for over three decades, but the measles burden is still high, causing 134,200 deaths globally in 2014. In Libya, a national mass measles vaccination campaign took place in 2005 targeting all residents of Libya age 9 months to 20 years between February 2005 5, and March 1, 2005. To date, no evaluation of its effectiveness has been conducted. Materials and Methods: Measles surveillance data were obtained for a 6 years' period (2002–2007) spanning the 3 years before and the 3 years following the mass vaccination campaign. The incidence of measles cases was calculated pre- and postvaccination campaigns and relative change in incidence was determined. Results: During the campaign 2,431,167 people age 9 months–20 years were vaccinated, resulting in a coverage rate of 98.4% in that age range. Comparing incidence of measles cases pre-and postvaccination campaign demonstrates an effectiveness of 96%, P = 0.021. Seasonality of measles cases was identified with a peak in April and May. Effectiveness varied by the age group, ranging from 82% in people lower than 5 years of age. Conclusion: A significant reduction was demonstrated following a national immunization campaign. Supplementary immunization campaigns should be initiated to keep the Libyan measles rate low; allowing the country to move into an elimination period.

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Background and Aim: The desire for reproduction is a basic human instinct, and it is well known that infertility is one of the psychosocial problems affecting many couples worldwide. The aim of this study is to evaluate the hormonal profile of infertile women in Bida metropolis. Materials and Methods: A total of 200 individuals comprising of 160 infertile and 40 fertile women as controls were recruited into this cross-sectional study in Bida metropolis, Nigeria. Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), progesterone, and estradiol were determined using enzyme immunosorbent assay. Results: Infertile women had significantly higher LH and PRL level (P < 0.05) and statistically lower progesterone and estradiol level (P < 0.05) when compared to fertile women. There was no significant difference in FSH level of infertile women (P > 0.05) when compared to fertile women. Nonmenstruating women (NMW) had lower FSH and progesterone level (P < 0.05) and significantly higher PRL and estradiol level (P < 0.05) when compared to MW. There was no significant difference in LH level of NMW (P > 0.05) when compared to MW. Hormonal abnormalities were observed in 83.3% of the infertile women. This comprises of 30% secondary hypogonadism, 20% hyperprolactinemia/hypogonadism, 13.3% primary hypogonadism, 13.3% hyperestrogenemia, and 6.7% hyperprolactinemia. Conclusion: This study has shown that infertility remains a major problem affecting women of childbearing age. It is therefore recommended that couples should seek medical care on time as well as determine their hormonal status to correct any abnormality that might have arisen.

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We report a case of heatstroke with rhabdomyolysis and myoglobinuria, which was complicated by cerebrovascular accident and myocardial infarction. Heatstroke can cause multiple serious systemic complications ranging from rhabdomyolysis to disseminated intravascular coagulation with multi-organ failure. However, it is also critical to consider its potential deleterious effects on the central nervous and cardiovascular systems. The complications of heatstroke can be explained by the combination of hypoperfusion and other mechanisms causing increased inflammatory response and thrombosis.

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Introduction: Apoptosis or programmed cell death is triggered by Fas-Fas ligand (FasL) binding. Mutation in the active sites of these genes blocks death signal transmission and ultimately causes carcinogenesis. The present case–control study was conducted to compare the relationship of age and serum prostate-specific antigen (PSA) with FAS-1377 G/A (rs2234767) polymorphism as one of the best-known polymorphisms of FAS in patients with prostate cancer and a group of controls. Materials and Methods: A total of 100 cases diagnosed with prostate cancer by a specialist and 100 healthy controls were selected from those presenting to the Urogenital Research Unit of Imam Khomeini Hospital in Tehran, Iran. The individual's blood samples were taken, and the enzyme-linked immunosorbent assay method was then used to isolate their blood serum and measure its PSA levels. The saturated salt solution method was used to extract the leukocyte DNA, and the individual's genotype was determined using the Restriction fragment length polymorphism-polymerase chain reaction technique. The data collected were analyzed in IBM SPSS-23. Results: The genotype count found genotype AA in 42% of the cancer patients and 36% of the controls (P = 0.384, odds ratio [OR] = 1.28 confidence interval [CI] 95%: 0.728–2.274), genotype GG in 57% of the cancer patients and 64% of the controls (P = 0.311, OR = 0.746, CI 95%: 0.422–1.317), and genotype AG in a single patient (1%) (P = 0.316, OR: 0.990, CI 95%: 0.971–1.010). No significant relationships were observed between the two groups in terms of these genotypes. Age and serum PSA were found to have significant relationships with both the AA and GG genotypes. Discussion: Older age and elevated serum PSA levels were found to be significantly related to the mutant genotype AA in the cancer patients. Given the lack of significant relationships between the risk allele A and prostate cancer, conducting a study with a larger sample size in different Iranian ethnic groups seems necessary, as sample size can affect the results obtained on this polymorphism.

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Background: Primary hyperparathyroidism (PHPT) is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in western countries but still predominantly as symptomatic disease in developing countries. The objective of this retrospective study was to describe the modes of presentation of this disease in Benghazi. Patients and Methods: Records of nineteen patients diagnosed with PHPT at metabolic bone disease clinic of Al Hawari general hospital, Benghazi, Libya, during 2005–2012 were reviewed. Results: Mean age at diagnosis was 41.7 ± 11.5 (range 20–70 years). There were 17 females and 2 males with a ratio of 8.5:1. Eighteen patients (94.7%) were symptomatic. Skeletal manifestations were the major mode of presentation in seventeen patients (89.4%) followed by renal stone in one patient (5.3%). All symptomatic patients had a single adenoma, nine of them (47.4%) had right inferior adenomas, and nine had left inferior ones (47.7%), and no adenoma can be detected in asymptomatic patient (5.3%). More than half of the patients had normal serum calcium levels (52.6%) at the time of diagnosis and (47.3%) had persistent hypercalcemia with a mean serum calcium level (10.7 ± 1.02 mg/dL), all patients had high serum intact parathyroid hormone with a mean value of (696.3 ± 379.5 pg/mL), and high serum alkaline phosphatase with a mean level of (901.9 ± 520.8U/L) except one patient who had low level of 20U/L. Vitamin D was measured only in six patients, five of them were a deficit, and one asymptomatic patient had normal level. All our patient's parathyroid adenomas were localized by Ultrasound. Seventeen patients had successful surgery, one patient had a recurrence, and one asymptomatic patient was managed medically according to the Third International Workshop guidelines. Conclusions: PHPT in Libya continues to be a severe, symptomatic disorder with skeletal, and renal manifestations at a much younger age.

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Rheumatic heart disease is among the most common acquired heart disease in Nigeria; it is a global disease, but greatest disease burden is in the developing countries; 50% of these are from African. Therefore, this poses a significant challenge to our health facilities; however, over the years, there has been a significant drop in the prevalence of this disease probably due to easy access to over-the-counter medications such as antibiotics. Chronic rheumatic heart disease commonly affects the mitral valves, the aortic valves, and rarely the right heart valves. Rarely, there is isolated aortic, pulmonary, or tricuspid valves' affectation without involving the mitral valve. Therefore, the case of a 12-year-old girl who presented with anasarca; and whose electrocardiogram showed right ventricular hypertrophy; and her echocardiogram confirmed isolated thickened tricuspid valve with severe tricuspid regurgitation is reported.

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