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Item Obscure Death And Bronchial Asthma.(Sebha University, 2005) El-Zentani, OthmanObscure death (OD) is a medico-legal dilemma; and it had not been well covered in the literature. It could be real OD if no cause was achieved after having all relevant data and conducting a complete standard autopsy followed by a series of complementary investigations. Or it could be relative OD if one or more of those important procedures or investigations were not performed, whatever were the circumstances. We had studied retrospectively, in detail, most of the parameters and variables related to obscure death cases in our institute for the period 01.01.1981-31.12.1992 inclusive, to find any correlation or association or not. And coup1ed with revision of the relevant literature, we had then discussed our results. Within that period studied, out of a total of 1445 autopsies (average autopsy rate was 120 autopsy per year), there were 106 cases of obscure death. Average OD rate in our institute was 7.34 % In fact, average OD rate is always below 10% (2.4% real. 7.34% relative). From our obscure death cases (N=106) we shall present two cases, where the difficulty to certify the cause of death as bronchial asthma is there. Often the forensic pathologist, if objective and unbiased, will label such cases as obscure death cases.Item Observations On 69 Hermaphrodites In Kuwait(Sebha University, 2005) Abdulhafid M. A. Zain, M. Y. El-Khalifa,* T. I. FaragItem Open Reduction and Internal Fixation of Distal Clavicle Fractures(Sebha University, 2010) Amit Swamy, Ajit Swamy,Clavicle fractures have been treated in the past by conservative means such as figure of eight bandage, sling and swathe etc. Although acceptable for middle and medial fractures, distal clavicle fractures often require open reduction and internal fixation. We present the results of 11 cases treated with open reduction and internal fixation with kirshner wires. Our results were good.Item Opportunistic Pathogenic Fungi from the Dust in Sebha Medical Centre, Libya(Sebha University, 2012) Tayyar, Ibrahim Ali AlFungi are one of the major biological components of the dust. Exposure to these fungi and them particles can cause respiratory disorders and fungal mycoses to human. The indoor environments of a hospital can affect on the health of patients, staff, and visitors and increase patient mortality, morbidity, and length of hospital stay and overall costs. A total 50 duplicated dust samples were collected during the period March - June 2012 from operating theatres (OT), intensive care units (ICU) and neonatal wards (NW) and sending for identification of microbiological agents. A total of 202 fungal colonies were isolated and identified. 83.7 % were molds and 16.3 % were yeasts. The average concentration per gram of dust in OT, ICU and NW was 65 CFU/g, 89 CFU/g and 48 CFU/g, respectively, with significant difference between the three units (P< 0.001). Diversity of fungal types showed no significant difference between the three units. From all isolated fungi,the major present types was Aspergillus spp.with 52.47%, Penicillium spp. with 22.27%, Candida spp. with 16.3%, and the other isolated fungal types were present in low percentages. Candida spp. was isolated during the study, four isolates (11.76 %) were identify as Candida albicans (Germ tube test positive), while 30 isolates (88.24 %) were Candida non-albicans spp. from total isolated yeast. Aspergillus, Penicillium, Candida, Bipolaris, Graphium, Curvularia, Fusarium, Epicoccu and Exophilia were identified in all studied units with different percent.Item Oral Mucosal Disorders in Denture Wearers(Sebha University, 2007) Ibrahim Safour, Jamal M. Sassi,This study was undertaken to report on the oral mucosal disorder seen in a clinic that is specialized in the diagnosis and treatment of oral mucosa disease at the diagnosis clinic of oral medicine department general hospital. The initial diagnostic evaluation was carried out by a dentist and a dermatologist. When additional work was required, patient were referred for laboratory studies radiography, or consultation with other specialists.Item Overall management of ankle fractures(Sebha University, 2013) F. Misrati, Tarek Ali Hemmali,Background: Ankle fractures are the most common injuries treated with variable functional outcomes. The introduction of the A0 classification has been facilitated analysis of the commonest fracture types. Aim of the study: The aim of this study is to know: (1) The age-specific incidence of ankle fractures. (2) The most frequent mechanism of injury. (3) The incidence of the different AO subgroups. (4) Immediate and early post operative complications related to ankle fracture. Materials and Methods: Sixty three patients were enrolled in my retrospective study, there were (38) men and (25) women; the period was from January 2007 to December 2008. The AO classification was used in the analysis of the fracture pattern. The hypothesis: In our opinion, the best anatomical reduction may be achieved by surgical treatment of ankle fractures that present with a talar tilt, fibular shortening and injury to the syndesmosis.Item Pattern of Myocardial Infarction and its Treatment in Libyan Females(Sebha University, 2007) Syed S. Ahmed, Mabrouk M. Mabrouk, Suha M. ElankahA retrospective clinical study of types of myocardial infarction (MI) in 200 Libyan female patients was undertaken in Tripoli Medical Center (TMC) from January 2001 to October 2004 (4 years), with age groups between 25 years to 97 years. The results indicate that most of the patients belonged to old age group (50-79 years). Extensive and antero-septal types of MI were most common types of MI. The vast majority of the patients were post-menopausal (95%). The condition was treated mainly with analgesics (morphine), anticoagulants and vasodilators. A further study to correlate lipid profile with the menopausal status is suggested.Item Pericystectomy for a Giant Recurrent Hepatic Hydatid Cyst(Sebha University, 2013) Elamyal, RamadanThe management of the recurrent giant hepatic hydatid cyst is often a controversial matter. Herein, is described a case of a 37 year-old female patient who was diagnosed with a giant hydatid cyst occupying almost the entire right lobe of the liver. After identification and protecting the surrounding tissues, antiscolicidal injection (alcohol 97%) and evacuation of the total contents of the cyst is done, the cyst is totally excised. The large residual cavity was simply drained. The patient had developed biliary collection which has been drained pcrcutaneously under ultrasound guidance. She has been discharged 34 days after surgery in a good condition. The clinical presentation, diagnostic work-up and surgical management of the patient are discussed, along with a review of the literature.Item Pit Falls in the Management of Neonatal Thrombocytopenia "Clinical audition"(Sebha University, 2007) Huda Elnaji, Ahmed Elgadra,Item Post Tonsillectomy Analgesia in Children with Paracetamol(Sebha University, 2011) Ahmed Aburwais, Abduljalil Wafa,Background: Pain, regardless of site can affect nearly every organ functions, and adversely influences postoperative morbidity and mortality. This study designed to compare the analgesic effect of paracetamol suppositories and intravenous formulas, theoretically delayed absorption and sub therapeutic plasma concentration can be avoided by giving drugs (Paracetamol) intravenously. Patients and methods: Prospective study, was done on 120 children aged between 6-10 years (73 females and 47 males), ASA class 1 and 2. All were subject to elective tonsillectomy. Patients were classified randomly into 2 groups. Group (A): They received paracetamol intravenously 15 mg/kg after induction of anesthesia. Group B: They received paracetamol suppositories 30 mg/kg after induction of anesthesia. In all standard anaesthesia were used. Postoperatively pain scale using the visual analogue scale assessed for each patient, the incidence of using opioids and the incidence of nausea and vomiting were measured. Results: Patients in group A were in slightly better analgesia in the first few hours postoperatively than those in group B and this supported by the statistical significant results (P<0.05) .Furthermore, The incidence of using rescue opioids and the incidence of nausea and vomiting are higher in group B than that in group A. However, they are not statistically significant (P>0.05). Conclusion: Intravenous paracetamol is more effective in post tonsillectomy pain management in paediatric than the suppositories.Item Postpartum Hemorrhage (PPH) Causes & Management(Sebha University, 2006) Elgadi, BashirPostpartum hemorrhage [PPH] is one of the major causes of maternal morbidity and mortality. Acknowledge of risk factors & active management of 3rd stage of labor will reduce PPH.Item Prevalence and Antibiotic Susceptibility Pattern of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated from Clinical Specimens in Eastern Province, Saudi Arabia(Sebha University, 2013) Ali Farag Hawad, Ibrahim Ali Al Tayyar,Staphylococcus aureus is environmental organism commonly found and most of them are opportunistic pathogens that colonized in human bodies cause various human disease. To determine the prevalence and antibiotic susceptibility pattern for multidrug and non-multidrug methicillin/oxacillin resistant S. aureus (MRSA) 133 S. aureus strains, isolated from different clinical specimens submitted to Department of Microbiology, Saad Speciality Hospital Laboratory, Saudi Arabia between November 2008 and September 2010. The percentage of MRSA and MDR were 39.1 % and 54.9 %, respectively. While the remaining strains were considered as Oxacillin sensitive S. aureus (OSSA) represented (60.9 %) more than half percentage of total isolated S. aureus. From 14 sample source of clinical specimens, the most common source of all isolated species combined was abscesses 62 (46.5%) isolate, followed by nasal swab 19 (14.3%) isolate, respiratory sample 14 (10.5%) isolate, wound 13 (10%) isolate, while the other teen source combined 25 (18.7%) isolate of all isolated S. aureus. S. aureus strains in general showed highly sensitive percentage to Vancomycin (100%), Linozolid (100%), Rifampin (98.5%), Nitrofurantin (97.7%) and Trimethoprim-Sulfamethoxazole (93.2). Moreover, the lowest sensitive rate was observed with Penicillin (3%), Ampicillin (4.5%), Ceftriaxon (22%).Item Prevalence of Hepatitis B and C Viruses among Libyan Blood Donors in Sebha Medical Center(Sebha University, 2013) Husein Ahmed Rashid, Abdulgader Saleh Ali,Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are associated with chronic liver disease and hepatocellular carcinoma, their magnitude is varies from country to another. They are transmitted through blood and its products as well. However, in Libya, most of the available data about these viruses are coming from mainly regional studies. Objective: The aim of this study was to determine the prevalence of hepatitis B and C among Libyan blood donors attending the Blood Bank Unit in Sebha Medical Centre, Sebha, Libya, during the year 2006. Materials and Methods: A total number of two thousand and two hundred thirty nine blood donors were assessed, all were apparently healthy males, and their age was between 20 and 50 years. Their serum was screened for hepatitis B and C viruses and HIV antibodies using an Enzyme Linked Immunoassay (ELISA, Biorex diagnostics, UK). Results: The proportion of HBsAg positive results was 3.17% (71/2239) and the negative result was 96.83% (2168/2239) and the prevalence of anti-HCV antibody sero-positive result was 1.34% (30/2239) and the majority was 98.66% (2209/2239) sero-negative. Interestingly, we found 100% seronegative HIV antibodies and syphilis (VDRL) among those donors. Conclusion: Our results may indicate that the possibility of transmitting hepatitis B and C virus from blood donors to patients is low, especially for the hepatitis C, HIV and Syphilis. Nonetheless, restricted regulation on blood transfusion is required for further minimization of the risk of the infection.Item Prevalence of Hepatitis B and/or Hepatitis C in 1 Haemodialysis Patients in Benghazi Renal Units(Sebha University, 2002) Ramadan M. Bujazia Ali O. El-Fitouri, A. Fatah Y. Zaied, Hanan. M.T. Bugaigis. Yasmina. A Al-Sharaki, Mohamed. H. Khafifi201 patients with end stage renal disease (ESRD) on maintenance haemodialysis (H.D) program, from 7th October and Hawari hospital renal units were studied for the prevalence of hepatitis B surface antigen (HbsAg) and or hepatitis C virus antibody (HCV Ab) by using the ELISA method (Hepanostika HbsAg unform II Organon Teknika) which qualitatively detects HbsAg subtypes ad and ay, and (UBI HCV EIA 4.0, United biochemical Inc. USA). It consists of synthetic peptides which correspond to the highly antigenic segments of HCV core regions (NS3, NS4, NS5) to detect HCV antibody. The study showed positive HbsAg results in 20 patients and positive HCV Ab in 133 patients and dual infections (HbsAg and HCV ab) in 23 patients with prevalence rates of 10%, 66.2% and 11.4% respectively. So the total prevalence rates for HbsAg and HCV antibody are 21% and 78% respectively. This study recommends more urgent preventive medical measures to be taken to decrease the prevalence rates of hepatitis B and or C viruses in HID units.Item Inttesttiinall Parasiittes i in Wadii All--Shattii Regiion(Sebha University, 2009) Awatif Mohamad Abdulsalam, Gelani Salem Saad, Abdul Hafeez Khan, Abdul Gader Ajaili, Mohamed Al-Shebani, and Yosef KubtiBackground: Intestinal parasites cause significant morbidity and mortality throughout the world. The prevalence of intestinal parasites is not recorded so far in the population of Wadi Al-Shati province of Libya. Objectives: to determine the prevalence of intestinal parasites among random population of different rural localities of Wadi Al-Shati province, south-west, Libya. Materials and Methods: a total of 1192 stool samples (during the period from 1st of August 2007 to end of April 2008) were collected from randomized population of seventeen rural localities of Wadi Al-Shati province. All stool specimens were examined by direct-smear microscopy, and formalin-ether concentration for the detection of intestinal parasites in normal saline and Lugol's iodine preparations. Results: Out of 1192 stool samples, 284 (23.82%) were found positive by the direct smear microscopy, and 294 (24.66%) by the formalin-ether sedimentation method. There was no significant difference (P>0.05) between direct smear and concentration method for the detection of intestinal parasites in stools. Prevalence of intestinal parasites between males and females was not statistically significant (P>0.05). Highest prevalence rates (5.70%) were found among 21 to 30 years old age group. Older age group (81 to 90 years) had a lower infected rate with intestinal parasites (0.08%). Blastocystis hominis was the commonest (20.21%) parasite found among the population. Cryptosporidium spp. (2.5%), Giardia lamblia (1.76%), Entamoeba histolytica/ E. dispar (1.17%) and Entamoeba coli (0.92%) were also detected in stool samples. Other intestinal parasites present included were Trichomonas hominis (0.80%) and Ascaris lumbricoides (0.80%). Conclusion: the helminthic infections are uncommon in Wadi Al-Shati province, probably due to climatic conditions (dry, hot and sandy soil) of this region. Prevalence of intestinal parasites would provide the baseline data to clinicians and health authorities for the treatment of parasitic infections in community of this region.Item Prevalence and Treatment of Glaucoma Disease in Tripoli Eye Hospital(Sebha University, 2008) W. Elrail, A. M. Giurnazi, M. M. Mabrouk, M. Jorush, and A Dau Masaud; W. Elrail, A. M. Giurnazi, M. M. Mabrouk, M. Jorush, and A Dau MasaudBackground: Glaucoma is actually a group of eye diseases that damage the optic nerve, which can be lead to vision loss and possibly blindness. Aim of the Study: The retrospective clinical study was undertaken to determine the most common types of glaucoma, age, sex incidence, diagnosis and treatment of glaucoma disease. Subjects and Methods: The information was collected randomly from 150 discharged patients included files (64 females and 86 male), with glaucoma disease admitted to Tripoli Eye Hospital (T.E.H) in Tripoli from 2001- 2003. The details of data present in the files were very carefully collected and were entered in the performa. The study included the most common types, age, sex incidence, methods of diagnosis and drugs used in the treatment of glaucoma disease. Results: The findings indicate high incidence of glaucoma disease especially open angle glaucoma (49%, n=74). The common age incidence (61-80 years) (54%, n=81). The diagnosis and treatment of glaucoma in Tripoli Eye Hospital has been focusing particularly on the drop off intraocular pressure (1.0.P.) follow up of optic disc cupping and find out visual defect. Conclusions: The findings reinforce the need for the clinical pharmacists to help physicians averting development of glaucoma 'disease.Item Prevalence of urinary tract infection among chronic renal failure in Khartoum state(Sebha University, 2013) Fadhil Al Obeid Omer, Nazar A. OsmanIntroduction: Urinary tract infection (UTI) is one of the most common infections and it account for about 1 – 2% of all consultation. It has been estimated that more than six million out-patient visits and 300,000 hospital stays every year are due to UTIs. Approximately 10% of humans will have a UTI at some time during their lives. Despite an increasing population of patients with chronic renal insufficiency, the literature on the management of urinary tract infections (UTI) in these patients is sparse. Objective: This study was conducted to detect the frequency of UTIs in chronic renal failure patients, isolate and identify the bacterial causative agents, determine the effective treatment and to study the validity of pyuria as indication to UTIs. Methods: Descriptive cross–sectional study was conducted at Khartoum state dialysis centers. The period of the study enrollment extended from April to August 2005. One hundred and ten patients suffering from chronic renal failure (CRF) were admitted into the study, fifty five urine samples were collected from patients diagnosed as chronic renal insufficiency and treated by conservative management. The other fifty five samples were collected from patients diagnosed as end stage renal disease and treated by haemodialysis. Results: Out of 110 CRF Patients, the frequency of UTIs (significant bacteruria) was 33 (30%) while there were no significant bacteruria in 77 (70.0%) of patients. E. coli was the commonest isolated organism 17(51.6%). Followed by E. faecalis, Klebsiella, S. saprophyticus, S. aureus, Proteus mirabilis, Citrobacter davisea that represent 6 (18.3%), 3 (9%), 3 (9%), 2 (6.1%), 1(3%), and 1(3%) respectively Conclusion: frequency of UTIs (significant bacteruria) and significant pyuria were 30% and 42.7% respectively. This frequency of UTIs was higher in haemodialysis than those on conservative management patients. The pyuria had high sensitivity and specificity in detection of significant bacteruria and so can use as screening test in patients suspected of having UTIs including CRF patients.Item Prevalence of Hepatitis B and C Infection among Children Who Presented With Acute Hepatitis 2nd March Hospital, South of Libya(Sebha University, 2005) Omran Muftah, Saad M. Othman,Objective: To determine the prevalence of hepatitis B virus and hepatitis C virus infection among cases of acute hepatitis in children. Sitting: 2nd March teaching hospital, Sebha, south Libya. Materials and Methods: This was a prospective hospital-based study of all children 15 years old and less who admitted to 2nd March teaching hospital and presented with acute hepatitis during the period from March 2004 to February 2005. The children were studied for the prevalence of HBsAg and HCV Ab by Rapid technique and ELISA. Results: The study showed positive HBsAg in 12 patients and HCV in 2 cases out 25 cases presented with acute hepatitis from a total of 1877 children 15 years old and less admitted to the paediatric department. Forty eight percentage 48% of hepatitis cases were hepatitis B virus infection and 8% were hepatitis C infection and in 11 cases (44%) not known because of unavailability of serological studies for other viruses. Conclusion: Hepatitis B infection which is avoidable disease by immunization still causing high percentage of hepatitis cases, so restriction to immunization is mandatory. Availability of serological studies of other viruses like A is important from epidimological point of view and as the hepatitis is notifiable disease.Item Prevalence of Giardiasis among Children from Wadi Al-Shati, Libya(Sebha University, 2013) Ali Daw, Saada Ali Al-Mubrook, Mohamed Chibani Mhamed and Abdul Hafeez KhanObjective: Small scale survey was performed to know the infection status of Giardia lamblia among children residing in nine villages rural localities of Wadi Al-Shati province, Libya. Methods: A total of 501 stool specimens, from were examined by direct smears (normal saline and iodine preparation) and formalin-ether concentration methods. Results: The overall prevalence of Giardia lamblia was 3.1% (16 infected) and there was no significant difference between the used methods (p> 0.05). The infection was found to be synchronized with other intestinal parasites, Entamoeba histolytica /E. dispar , E. coli and with B. hominis. In general, girls were more infected (3.8% , 10) than boys (2.5%, 6). However, difference between them was not statistically significant (p> 0.05). The highest prevalence (7.4%) of G. lamblia was found among 12 to 14 years old age group and lowest (0.9%) was found among less than one year group. The prevalence of infection was associated with overcrowding of the family (p = 0.011), body waste disposal (p = 0.000), floors of homes (p = 0.000), and water supply (p = 0.043). Abdominal pain was the most common symptoms (0.75%). Conclusion: The present study offers first epidemiological attempt to report the prevalence of giardiasis among children living in different villages of Wadi Al-Shati province. This region could be classified as low prevalence area for giardiasis . However, more studies are needed in order to delineate the predictors associated with Giardia infection in Libya.Item Prevalence of Intestinal Parasitosis among Food Handlers in Benghazi, Libya(Sebha University, 2011) Khan A.H. and Ali Daw, Yosef Kubti, Muftah Y. AliBackground: A substantial percentage of food handlers may be the carriers of many intestinal parasites. Handling of food and drinks by infected individuals in the society promotes transmission of intestinal parasites. Objectives: To determine the prevalence of intestinal parasites among food handlers in Benghazi. Material and Methods: A total of 3150 food handlers submitted their faecal specimens to get health clearance certificates to the Central Lab in Benghazi during the period of May 2005 to April 2006. All faecal specimens were routinely examined by direct smear microscopy and concentration method or intestinal parasites. Results: Two hundred sixty one (8.26%) food handler professionals were found infected with intestinal parasites. Prevalence rate was significantly (p<0.05) higher among Sudanese (9.40%) and Egyptian (7.51%) food handlers compared to Libyan (4.96%) food handlers. The most common parasite was E.histolytica (4.4%) among these professionals. Conclusion: Import of intestinal parasites by expatriate workers arriving from neighboring countries, such incidence patterns seems to become a persistent feature in the region. To minimize intestinal parasites, medical health care and revamping hygiene measures of food handlers is necessary.