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ORIGINAL ARTICLES
Comparison of efficacy of mulligan's mobilization with movement with maitland mobilization along with conventional therapy in the patients with knee osteoarthritis: A randomized clinical trial
Aniqa Kiran, Muhammad Junaid Ijaz, Muhammad Mustafa Qamar, Ayesha Basharat, Akhtar Rasul, Waqas Ahmed
January-June 2018, 3(1):26-30
DOI:10.4103/LIUJ.LIUJ_12_18  
Objective: The objective of this study is to determine the outcome and efficacy of Mulligan's mobilization with movement (MWM) with Maitland mobilization along with conventional therapy in the patients with knee osteoarthritis (OA). Materials and Methods: A randomized controlled trial study was performed at the Department of Physiotherapy, Mayo Hospital, Lahore, Pakistan. Sixty-two patients were selected for the study. MWM was introduced in half of the patients and Maitland mobilizations in the second half for 2 weeks. The goniometry, visual analog scale (VAS), knee range of motion (ROM), and Western Ontario McMaster OA (WOMAC) Index for knee OA were the assessment tools used to assess all patients before and after 2 weeks of intervention. Paired sample t-test was used for analysis of results. Results: The mean pre- and postdifferences in MWM group were 4.06 ± 0.99, 10.19 ± 3.87, and 19.41 ± 7.58 for VAS, ROM flexion, and WOMAC Index, respectively, while the pre- and postmean difference values for Maitland mobilization group were 3.355 ± 1.05, 10.19 ± 5.5, and 12.28 ± 7.029 for VAS, ROM flexion, and WOMAC Index, respectively. The mean differences of both treatment interventions individually were significant and showed that both were clinically effective in treating the patients of knee OA. Conclusion: It was concluded that patients in both groups showed improvement in pain, ROM, and functions.
  747 131 -
Effects of the aqueous extract from Abelmoschus esculentus L peel on hyperglycemia and hyperlipidemia induced by dexamethasone in rats
Aisha Mohamed Dugani, Wesal Issa Alkhetally, Elham Omran Elghedafi, Feras Walid Alkayed
January-June 2018, 3(1):3-7
DOI:10.4103/LIUJ.LIUJ_1_17  
Background: Hyperglycemia and hyperlipidemias are common clinical problem among users of glucocorticoids (GCs). The aim of the present study was to explore the effect of oral administration of the aqueous extract of Abelmoschus esculentus peel (AEPE) on hyperglycemia and hyperlipidemia induced in rats by dexamethasone (DEXA). Methods: Twenty-four rats were randomly divided into four equal groups. Each group was treated for 10 days either with 2% carboxymethylcellulose orally (normal control); 10 mg/kg DEXA subcutaneously (hyperglycemic group); 100 mg/kg AEPE orally plus 10 mg/kg DEXA subcutaneously (treatment group 1); or 200 mg/kg AEPE orally plus 10 mg/kg DEXA subcutaneously (treatment group 2). Animals were killed after 10 days of treatments by decapitation, their blood collected for the analysis of blood sugar and lipid profile. Results: Treatment with DEXA induced a significant increase in blood glucose and all lipids and a significant reduction in body weights. After 10 days of treatment, 100 mg/kg of AEPE was able to significantly reduce the effect of DEXA on triglycerides and low-density lipoprotein (LDL) only. 200 mg/kg of AEPE was able to significantly reduce the effect of DEXA on blood glucose levels, cholesterol, triglycerides, and LDL. Both doses of AEPE were able to increase high-density lipoprotein. Conclusion: This study suggests that the AEPE could be beneficial in protecting against GC-induced hyperglycemia and hyperlipidemia.
  523 81 -
EDITORIAL
Assessment and prospective for Libyan international Medical University Journal: New phase of development
Abdalla Salem Elhwuegi
January-June 2018, 3(1):1-2
DOI:10.4103/LIUJ.LIUJ_1_18  
  391 96 -
ORIGINAL ARTICLES
The physical, chemical, and microbiological stability of chloramphenicol ophthalmic solution
Tauwfik Mohamed Salih, Idris Mohamed El-Mahdi
0, 0(0):0-0
DOI:10.4103/2519-139x.237043  
Aims: The aim of this work is to “predict” the remaining shelf-life of chloramphenicol (CH) eye drops, commercially marketed, using the theoretical “Longland–Rowbotham model,”” followed by confirmation of findings by practical means. Materials and Methods: The methods used for the evaluation of CH-eye drops included the assay of the active ingredient, sterility testing, and minimum inhibitory concentration (MIC) determination using official methods during 6 months stability study at variable temperatures (4, 25°C). Furthermore, a 3-month accelerated stability study was carried out. Statistical analysis tests included Student's t-test and analysis of variance. Results: The prediction model indicated that in pessimistic conditions, the remaining shelf life was reduced to a merely 1 month following production (this is versus the 2 years expiration date given by manufacturer). However, the samples analyzed throughout a 6-month stability study revealed that storing CH solution at 4°C or 25°C does not produce any statistical difference regarding drug content, MIC, or sterility. Accelerated stability studies for 3 months period showed that only after 2 months from storage at 55°C the drug will start to degrade and a statistical difference could be observed. Conclusion: Storing CH-eye drops at room temperature for up to 6 months appears to have no effect on the stability of this antibiotic.
  464 16 -
Influence of micronization on the physical properties of salbutamol sulfate as a model drug used in dry powder inhalation
Antesar M Boshhiha, Nora Anne Urbanetz
January-June 2018, 3(1):8-15
DOI:10.4103/LIUJ.LIUJ_4_18  
Purpose: Investigation of the crystallinity of salbutamol sulfate a model drug used in the dry powder inhalation formulation. Materials and Methods: Salbutamol sulfate was supplied kindly by Lindopharm (Hilden, Germany). Salbutamol sulfate was milled using an air jet milling process, the particle size and morphology were determined using laser diffraction and the scanning electron microscopy. The drug was subjected to conditioning through storage at 52.8% and 75% relative humidity for 24 h, 1 week, and 2 weeks, respectively. The drug crystallinity was investigated using differential scanning calorimetry (DSC), X-ray diffraction, and water vapor sorption techniques. Results and Discussion: Conditioning of salbutamol sulfate after micronization lowers the glass transition (Tg) temperature of the amorphous parts present at particle surface, which enhances particle mobility for more rearrangement associated with water expelling. This transformation may result in deviation from the original particle size obtained after milling out of respirable range. DSC and X-ray diffraction show no detectable amorphous drug since no detectable Tg observed. Alternatively, water vapor sorption shows a small amount of amorphous salbutamol sulfate at the particle surface, which recrystallizes at 52.8% relative humidity after approximately 2 weeks of conditioning. Conclusion: The amorphous regions can be generated in crystalline materials during processing. The level of amorphous materials can affect every step of pharmaceutical formulation, storage, and stability. However, quantification of low levels of amorphous content still poses considerable challenge. This study confirms that, the water vapor sorption technique is useful in the quantification of a small amount of drug amorphous content.
  336 63 -
REVIEW ARTICLES
Introduction to nanotechnology: definition, terms, occurrence and applications in environment
MHS Ahmeda, NHS Ahmida, AA Ahmeida
January-June 2017, 2(1):12-26
DOI:10.21502/limuj.003.02.2017  
Nanotechnology is an emerging multidisciplinary technique that involves application based on the synthesis of molecules in nano-scale size range. Nanotechnology is also seen as new and fast emerging field that involves the manufacture, processing and application of structure, device and system by controlling shape and size in nanometer scale. The concept of nanotechnology is driven from the Greek word nano (meaning dwarf). The nano-particles are defined as a discrete entity that has dimensions of the order of 100 nm or less. It is the small size in combination with the chemical composition and surface structure that gives the nano-particles their unique features. The alterations in physical properties serve to enhance versatility and efficacy in product development, resulting in more effective industrial and medical applications. As a result of the widespread use of nanotechnology and nano-materials, these particles find their way into the environment. Therefore, a focus on the source of nano-particles in the environment and their effects is included. This review concentrate on the recent information about analytical developments to assess the occurrence, fate and behavior of nano-materials in environment. It also focuses on the applications of nanotechnology in environment, especially in the area of air and water purifications.
[ABSTRACT]   Full text not available  [PDF]
  298 86 -
ORIGINAL RESEARCH ARTICLE
Knowledge, attitudes and practices of personal protective measures among hemodialysis nurses in Benghazi
LJ Abdulmalek
July-December 2017, 2(2):101-111
DOI:10.21502/limuj.013.02.2017  
BACKGROUND: This study intended to assess knowledge, attitudes, and practices regarding standard precautions concerning health care-associated infections (HAIs) among hemodialysis nurses in hemodialysis centers in Benghazi. METHODS: the study was a cross sectional study carried out during the period from 1-3-2014 till 30-9-2014. The data was gathered from hemodialysis nurses in hemodialysis centers in Benghazi by using a questionnaire and by direct interview. RESULTS: There were a total of 59 hemodialysis nurses in hemodialysis centers in Benghazi. All agreed to participate in the study. Although 92% of the nurses knew that their hands could be a source of health care-associated infections, but only 52% of nurses washed their hands before contacting another patient. Gloves were actually used by 98% of the nurses. 46% of the nurses were usually wearing masks when contacting a patient. Books and journals were the main source of information about (HAI) among 52% of the nurses. CONCLUSION: The nurses' knowledge of health care-associated infections did not modify their adherence to hand hygiene practices. This study recommend training programs for hemodialysis nurses about promoting higher hand hygiene standards and potential use of personal protective measures during their shifts in hemodialyais centers.
[ABSTRACT]   Full text not available  [PDF]
  248 113 -
ORIGINAL ARTICLES
Sutureless and glue-free conjunctival autograft for pterygium surgery: A preliminary report about Libyan experience
Naeima M Elzlitni, Sabah S Eldressi, Samar A Bukhatwa
January-June 2018, 3(1):16-19
DOI:10.4103/LIUJ.LIUJ_8_18  
Aim: The aim of this study was to evaluate the efficacy and outcome of sutureless and glue-free conjunctival autograft for the management of primary pterygium in terms of complications such as loss of graft, graft dehiscence, and recurrence rate. Materials and Methods: A case series study was carried out in March 2015 at Nastaein private sanatorium, Zlitin, Libya. Twenty-seven eyes of 23 patients with primary pterygium were included in this study. Pterygium excision with conjunctival autografting without using sutures or glue was done to all patients. The patients were followed up postoperatively after 1 h, 1st day postoperatively, and then 1 week, 4 weeks, 3 months, 6 months, and 12 months. Results: The mean age of the patients was 55.9 ± 8.55 years (range: 43–71 years); 65% were male. Mean follow-up time was 10.2 ± 2 months. Changes of visual acuity were not noticed in any of these patients. Only one patient (3.7%) developed edge recession of the graft on the 1st postoperative day due to a wrong measurement of the size of the graft, and no other complications were noted. Cosmesis was excellent in all cases and no recurrence was noted. Conclusions: Sutureless and glue-free conjunctival autograft for primary pterygium surgery is a safe and effective way for the management of primary pterygium.
  261 42 -
Prevalence of metabolic syndrome and its components in nondiabetic Libyan females
Hawa Juma El-Shareif
January-June 2018, 3(1):20-25
DOI:10.4103/LIUJ.LIUJ_9_18  
Background: The metabolic syndrome (MS) is defined as a cluster of cardiovascular risk factors, including central obesity, dysglycemia, hypertension (HPN), elevated triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C). MS increases the risk of cardiovascular disease and all-cause mortality. Objective: This study aims to estimate the prevalence of MS and its components among nondiabetic Libyan females using the definition proposed by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Methods: A total of 122 randomly selected nondiabetic Libyan females were included in the study. Detailed medical history was obtained from all participants. Blood pressure, weight, height, waist and hip circumference were measured. Body mass index and waist–hip ratio were calculated. Fasting blood glucose (FBG) and lipid profile were collected. Standard oral glucose tolerance test with 75 GM glucose was performed. The MS was defined by ATP III and International Diabetes Federation criteria. Results: According to NCEP definition, the prevalence of the MS in the study group was 42.6%. The most common component was abdominal obesity (67.2%). FBG was ≥ 100 mg/dl in 47.5%. The prevalence of both HPN and low HDL-C was 45.9%. About 26.2% of the participants have their TG ≥ 150 mg/dl; all were MS patients. Conclusions: The prevalence of MS and cardiovascular risk factors were high among Libyan females. Public health authorities and health-care providers should implement strategies for prevention, screening, and management of cardiovascular risk factors to reduce the burden of its potential complications.
  242 45 -
REVIEW ARTICLES
Impact of chronic stress on cardiovascular system: Libyan conflict health perspective. Part one: Types of chronic stresses
Abdalla Salem Elhwuegi, Lamis Ali Teebar
0, 0(0):0-0
DOI:10.4103/LIUJ.LIUJ_25_18  
Recent studies have provided clear and convincing evidence that chronic stress contributes significantly to the pathogenesis and expression of cardiovascular diseases (CVDs). This bibliography is a systematic review on the impact of chronic stress on the cardiovascular system with a special reflection on the Libyan conflict. It is divided into two parts, Part 1 deals with types of chronic stresses, while Part 2 deals with mechanisms involved in chronic stress and their treatments. Medline/PubMed, Google Scholar, and Scopus databases were used to search for peer-reviewed papers dealing with the review theme. Stress can be classified into acute stress and chronic stress. Chronic stress can stem from underlying factors such as economic stress, social isolation stress, posttraumatic stress, and job strain stress. Economic stress is emerging as an important determinant of perceived health where different studies have found an inverse trend between risk factor burden and cardiovascular disease prevalence in urban and rural communities in high-, middle-, and low-income regions. Social stress is another factor that has been reported to be associated with a 2–3 fold increase in the incidence of CVD. Moreover, multiple studies have shown that patients suffering from posttraumatic stress disorder have increased resting heart rate, increased startle reaction, and increased blood pressure as responses to traumatic events. CVD is one of the health outcomes whose links with work stress have been well established based on numerous prospective studies.
  160 3 -
ORIGINAL RESEARCH ARTICLE
Tooth size discrepancy in different malocclusion groups in Libya: a pilot study
F Elsheikhi, I Bugaighis, T Hamed
July-December 2017, 2(2):92-100
DOI:10.21502/limuj.012.02.2017  
Background: Orthodontists need to evaluate intermaxillary tooth size discrepancy (TSD) prior to initiating treatment in order to achieve a stable treatment. Thus, the aim of the present study was to determine the prevalence of TSD in Libyan subjects among different malocclusion groups. Methods: A sample of 60 dental casts of Libyan subjects with different types of malocclusions (Class I, Class II div 1 and Class III) were included in the study. Each malocclusion group (20 dental casts) included equal numbers of males and females, 12-17 years of age. Mesio-Distal tooth measurements were extracted to compute the anterior and overall TSD ratios. Paired Student t-test was used to detect significant discrepancies between the paired teeth measurements. Analysis of Variance (ANOVA) and Tukey Honestly tests were undertaken to detect significant discrepancies among the malocclusion groups. Results: Paired t-test revealed that there were no significant discrepancies between the paired tooth widths except for the upper first molars, upper first premolars, lower lateral incisors and lower canines (P<0.010). ANOVA found no significant differences in the mean anterior TSD ratio in regard to malocclusion groups. However, a significant disparity was noticed in the mean overall TSD ratio among the different malocclusion categories (P<0.04). Conclusion: Statistically significant TSD between the examined malocclusion groups were observed only in the mean overall TSD ratio.
[ABSTRACT]   Full text not available  [PDF]
  110 22 -
EDITORIAL
Higher education in Libya: Challenges and future plans (in Arabic language)
Mustafa M El-Fakhri, Salma A Bukhatwa
January-June 2016, 1(1):27-34
DOI:10.21502/limuj.004.01.2016  
Educational institutions are the principle pillars for establishment of sustainable human development which leads to community progress. Therefore, it is essentially important to develop their infrastructure, programs, and financial resources and assure the quality of their outcome to effectively respond and fulfill community needs. With current unprecedented scientific advancement in all aspects of life, it is becoming a formidable task to stay internationally competent. Continuous development and improving educational programs are therefore a must. The future requirements of education are choosing quality over quantity and adopting modern, reliable teaching methods in order to acquire knowledge, develop skills and attitudes that comply with good professional practice to meet the challenge of globalization. Education in Libya is free for everyone from elementary school up to university level but the general decline in the quality of Libyan higher educational system within the last four decades is well recognized. The efficiency of its product has been proven to be inconsistent with the national economical and developmental needs. Internal challenges of the higher educational system in Libya that affecting its own performance are presented in this paper, even though this does not under estimate the effect of other external threats, but they just remain beyond the scope of this paper. These challenges include; lack of a national strategic plan, poor primary and secondary school output, excessive students' admission, structural problems, poor infrastructure, administrative and legal problems, poor academic staff performance, outdated curricula and teaching methods, poor financial resources, poor research and postgraduate programs. Inevitably, the first step in treatment of such situation is to adopt a national strategy for higher education to know where we stand and to decide where to go and how to reach there. This of course in addition to linking educational programs to local, national and international market needs and promoting investment in education.
[ABSTRACT]   Full text not available  [PDF]
  84 28 -
ORIGINAL RESEARCH ARTICLE
Antimicrobial resistance profile and molecular characterization of methicillin-resistant staphylococcus isolates in Tripoli Central Hospital, Libya
SM Aetrugh, MA Aboshkiwa, WM Husien, ME Erhuma, M Corrente, E Grandolfo, MS Ellabib, TM Emahbes, MI Mustafa
January-June 2017, 2(1):74-83
DOI:10.21502/limuj.010.02.2017  
Background: Nosocomial infections caused by methicillin-resistant Staphylococci could lead to increased morbidity and mortality, but little is known about the prevalence of infections with these organisms in healthcare facilities and in the community in Tripoli. This study investigated the in vitro susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative staphylococci (MRCNS) to antimicrobial agents, and determined the molecular characteristics of MRSA. Methods: This is a retrospective observational study aiming at determining the prevalence and antibiotic resistance pattern of (MRSA) and (MRCNS) isolated from non-duplicated clinical specimens in Tripoli Central Hospital (TCH) between June 2013 and June 2014. Isolates were identified using standard laboratory procedures. Antimicrobial susceptibility tests were carried out by disk diffusion method and automated systems. DNA of the MRSA isolates was used for PCR to determine the molecular analysis. Results: 218 isolates of Staphylococci were obtained, 71.6% were coagulase positive staphylococci (CPS) and 28.4% were coagulase negative staphylococci (CNS). 39.7% of CPS were MRSA, while 75.8% of CNS were MRCNS. The rates of hospital-acquired MRSA (HA-MRSA) and community-acquired MRSA (CA-MRSA) among MRSA isolates were 61.3% and 38.7% respectively. A similar trend was detected among MRCNS isolates, where 74.5% were HA-MRCNS and 25.5% were CA-MRCNS. All the MRSA and MRCNS isolates were susceptible (100%) to vancomycin, tigecycline, linezolid, quinupristin/dalfopristin, daptomycin and moxifloxacin. Generally, hospital-acquired strains showed higher resistance rates than community-acquired ones to the most commonly tested non-beta-lactam antibiotics. 35.5% of all staphylococcal isolates exhibited mecA+ gene and 12.9% expressed mecC+. Meanwhile, 38.7% of MRSA isolates harbored both mecA and mecC. However, 12.9% of MSSA isolates were negative for both mecA and mecC. The mecA gene was detectable in 59.1% and 40.9 % of HA-MRSA and CA-MRSA isolates respectively. Conclusion: Hospital-acquired MRSA and MRCNS isolates had higher resistance rates to non-beta lactam antimicrobial drugs than the respective community-acquired isolates. This was shown by early detection of mecC gene among MRSA isolates.
[ABSTRACT]   Full text not available  [PDF]
  85 23 -
Beta-adrenergic receptor blockers effects on the antinociceptive action of imipramine against thermal induced pain in albino mice
HA Zawia, FA Blaou, AS Elhwuegi
January-June 2016, 1(1):17-26
DOI:10.21502/limuj.003.01.2016  
Introduction: Tricyclic antidepressant have been shown to be effective in treatment of pain of varying etiology, monoaminergic system seems to be implicated in this phenomena. This research examines the role of beta-adrenergic receptor blockers on the antinociceptive effect of imipramine in albino mice using thermal model of pain. Methods: Different groups of five animals each were injected intraperitoneal by different doses of imipramine only (2.5, 7.5,15, 30 mg/kg), atenolol (2 mg/kg), propranolol (6mg/kg), or the combination of the different doses of imipramine with the fixed dose of atenolol or propranolol. The degree of analgesia was measured as an increase in reaction time to pain in the hot plate one hour after drugs injections. Results: Imipramine produced dose dependent increase in reaction time from 129% with the lowest dose to 196% with the highest dose. One-way ANOVA analysis has shown that the addition of a fixed dose of propranolol antagonized significantly the increase in reaction time to 75% with the lowest dose and 118.9% with the highest dose of imipramine. On the other hand, atenolol failed to antagonize significantly the increase in reaction time induced by imipramine. Conclusion: Imipramine has a significant analgesic effect on albino mice in the hot plate test. The antinociceptive action of imipramine seems to be of central origin and possibly mediated, at least in part, by beta adrenergic receptors, as this analgesic effect can be blocked by propranolol, a centrally acting non-selective beta adrenergic receptor antagonist, but not with atenolol which blocks only the peripheral beta receptors.
[ABSTRACT]   Full text not available  [PDF]
  90 16 -
Studies and evaluation of compressed microspheres
Idris M El-Mahdi, Atef M Madi
January-June 2016, 1(1):6-16
DOI:10.21502/limuj.002.01.2016  
This work was aimed at the use of dissolution testing and similarity factor to assess the level of damage taken by active drug microspheres during compression in tablet dosage form. To achieve that, combinations of suitable excipients were used to protect drug microspheres during compression. The excipients were used in the form of powders, granules or placebo pellets prepared by extrusion-spheronization technology. The excipients were evaluated alone, in combinations and post-compression into compacts. Preliminary experiments included assessing density, hardness, friability and disintegration of all the selected excipients. Based on such experiments it was found that the flowability of combination of powders was more acceptable than individual excipients. Two combinations of microcrystalline -starch and microcrystalline cellulose -calcium carbonate granules were selected to be compressed with pellets of the active pharmaceutical ingredient ketoprofen. In all the combinations used there was a significant amount of damage to drug pellets. The kinetics of drug release appears to follow the zero-order rate, which remained unchanged even when a significant degree of damage to pellets occurs. It was found that a high level of excipients is required in order to prepare microspheres as a rapid disintegrating tablet.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  89 14 1
ORIGINAL ARTICLE
Prevalence and types of bacterial infections of the upper respiratory tract at a tertiary care hospital in the City of Tripoli
Ahmed Atia, Ahmed Abired, Anees Ammar, Najla Elyounsi, Abdulsalam Ashour
0, 0(0):0-0
DOI:10.4103/2519-139x.239558  
Aim: The study aimed to determine the bacterial etiology of upper tract respiratory infection in Abu-Sitta Hospital, Tripoli, Libya. Subjects and Methods: A total of 470 sputum specimens and 60 throat swabs were collected over a period of 1 year (From January 2014 to December 2014) from patients presented with clinical signs of upper respiratory tract infection at Abu-Sitta Hospital. Enrolled patients were sorted as inpatients or outpatients and by gender. Data were entered and analyzed using SPSS version 22.0. Variables were expressed as percentages. Differences in age and gender were analyzed using Chi-square test. Results: Of the total 530 screened samples, 80.5% were culture positive, where bacterial pathogens were detected in 83.7% of sputum specimens and in 56.5% of throat swabs. Streptococcus pneumoniae was the most prevalent (48%), followed by Pseudomonas aeruginosa (23%), Staphylococcus aureus (13%), Enterobacter (8%), Citrobacter freundil (5%), and latest with Klebsiella (3%). Conclusions: The spectrum of pathogenic bacterium causing upper respiratory infection in Abu-Sitta Hospital is considerably wide, with S. pneumoniae and P. aeruginosa being the major causative bacteria.
  94 8 -
ORIGINAL RESEARCH ARTICLE
Reduction of cholesterol and fasting blood sugar levels by one month supplementation of fresh garlic in diabetic Libyan patients: A double blind, baseline controlled study
AI Banigesh, AR Hamad, AA Dihom, IM El-Mahdi
January-June 2017, 2(1):47-54
DOI:10.21502/limuj.007.02.2017  
Background: The therapeutic effects of fresh garlic remain controversial. The aim of this study is to investigate whether supplementation of fresh garlic could improve blood glucose and cholesterol profile in Libyan diabetic patients with moderate blood cholesterol. Methods: Forty-six diabetic patients were randomly assigned to either fresh garlic alone (≈2 grams/day), or fresh garlic in combination with glibenclamide taken on an empty stomach every morning for a month. Serum blood glucose, cholesterol and blood pressure were measured before starting treatment and after the end of the treatment period. Results: Fresh garlic alone was able to decrease the mean serum cholesterol levels by 26 mg/dl (84% of the original base values), while the combination of fresh garlic and glibenclamide produced a 28 mg/dl decrease in the mean serum cholesterol (85% of the original base values). Fresh garlic alone was able as well to decrease the mean blood glucose levels by 20 mg/dl (85% of the original base values), while the combination of fresh garlic and glibenclamide produced a 60 mg/dl decrease in the serum glucose levels (72% of the original base values). Neither treatment had a significant effect on the mean systolic or diastolic blood pressures after 30 days of treatment. Conclusion: Administration of fresh garlic every morning for a month significantly reduced the blood cholesterol and fasting blood glucose levels in diabetic patients. Thus administering dietary fresh garlic daily to diabetic patients might have cardio-protective effects on diabetic patients.
[ABSTRACT]   Full text not available  [PDF]
  78 22 -
Undescended testis: timing of referral and surgical intervention, Urology Center, Benghazi, Libya
OA Tarhoni, AM Etabbal, AF Trkawi
July-December 2017, 2(2):120-127
DOI:10.21502/limuj.015.02.2017  
BACKGROUND: Undescended testis (UDT) is the failure of testes to descend into the scrotum. It is classified according to the site of arrest into; Intra-abdominal, deep inguinal ring, canalicular, or emergent from the superficial inguinal ring. The diagnosis of UDT is mainly clinical and its treatment is usually surgical. The aim of our study is to analyze age distribution at the time of diagnosis and treatment to determine if the international guideline recommendations are followed in our institution or not. PATIENTS & METHODS: A retrospective study was carried at Urological Center by reviewing the files of 75 consecutive patients admitted to the hospital in the period from July 2011 to April 2014. A data flow sheet was used to record and analyze the patients' personal data, age at diagnosis, physical findings, type of surgical procedure, and the age of the patients at the time of surgery, as well as surgical findings. RESULTS: Total number of patients enrolled in the study was 75 patients. Fifty-two cases were diagnosed at birth, 14 cases discovered incidentally, and 9 cases were presented with reducible inguinal swelling with or without pain. The 75 patients had 93 UDTs, 49 UDTs on right side and 44 UDTs on left side. Sixty-nine UDTs were clinically palpable while the other 24 UDTs were not palpable (74.2% and 25.8% respectively). The mean age at the time of diagnosis was 3.7 ± 8.3 years. However, the mean age at the time of surgery was 10.8 ± 10 years. The surgical procedures performed were: orchiopexy (n=58, 62.3 %,), orchiopexy combined with ipsilateral hernial repair (n=16, 17.2%) and orchiectomy (n=19, 20.4%). CONCLUSION: In our institution, the mean age at orchiopexy was significantly delayed beyond the recommended time of surgery because of delayed diagnosis or referral.
[ABSTRACT]   Full text not available  [PDF]
  84 15 -
Evaluation of pearl millet starch as tablet disintegrant
BY Mhana, JS Mezogi, MA El-Majri, AM Abushoffa
July-December 2017, 2(2):152-163
DOI:10.21502/limuj.019.02.2017  
Objectives: This study aims to evaluate a novel tablet excipient obtained from local sources, Pearl millet Pannistumamericanum starch of family Poaceae which is used locally as food because of its high carbohydrate content. It was thought that the starch of Pearl millet Pannistumamericanum may serve as a tablet disintegrant. Methods: The excipient properties of Pearl millet starch as well as the pregelatinized form were studied in paracetamol tablets produced by wet and dry granulation methods of massing and screening and compared with maize starch BP. Results: Wet method showed superiority in all properties of both granules and tablets. Using wet method granulations Pearl millet Pannistumamericanum starch and maize starch BP have similar angle of repose, Carr's index, tapped density, bulk density, and Hausner's ratio, however, Pearl millet Pannistumamericanum starch has shown advantageous in some properties such as moisture content and swelling index. Tablet produced with Pearl millet Pannistumamericanum starch disintegrated almost the same of those produced with maize starch BP at all concentrations employed. It was also found that when used as a disintegrant, the pre-gelatinized form provide tablets with better hardness and friability values than maize starch BP. Conclusion: This study confirmed the suitability of Pearl millet Pannistumamericanum starch as an alternative to maize starch BP as a tablet disintegrant, particularly, in paracetamol tablet formulation.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  76 16 1
Knowledge towards breast cancer among Libyan women in Tripoli
YA Taher, AM Samud, GM Benhusein
January-June 2016, 1(1):58-68
DOI:10.21502/limuj.007.01.2016  
Introduction: Breast cancer in women is the commonest type of cancer worldwide. However, in Libya, ordinary systematic screening for breast cancer is neglected. Aim: The present study was aimed to evaluate the women's knowledge towards breast cancer and its risk factors. Methods: A cross-sectional survey, using self-administered questionnaire and face-to-face interviews was conducted at different places in Tripoli city along a period of nine months, from April-December 2013. Results: The mean age (±bSD) of the participating women was 48±b5 years and out of 284 contributors 84.5% were married. One hundred and eighty women (63.4%) stated that long-term use of contraceptive pills (> 5 years) increases the incidence rate of breast cancer. Besides, more than half of participants (157 women) specified that breast cancer is treated by surgery, chemotherapy and radiotherapy. However, although 50.7% of women reported that mammography and ultrasound are used for early detection, more than 60% of women believed that mammogram can cause cancer. In addition, our data demonstrate that increased knowledge was associated with women who know how to do self-examination and living in urban area. Conclusion: Our findings demonstrate that Libyan women have acceptable level of knowledge regarding breast cancer. However, improvement of the health systems and awareness regarding breast cancer is needed.
[ABSTRACT]   Full text not available  [PDF]
  65 25 -
Pattern of ocular trauma in Benghazi eye hospital, Benghazi, Libya
MM Gebril
January-June 2017, 2(1):40-46
DOI:10.21502/limuj.006.02.2017  
Background: This study was conducted to determine the pattern of ocular trauma in Benghazi- Libya. Methods: All cases of ocular trauma admitted to Benghazi eye hospital from January 2011 to August 2012 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury. The injuries were classified by Ocular Trauma Classification System. Results: Out of the 805 patients, there were 540 patients (67.0%) with Closed Globe Injury and 254 patients (31.5%) with Open Globe Injury and 11 patients (1.3%) with mixed trauma. Conclusion: This analysis shows a pattern of eye injury largely similar to reports from other parts of the world. Eye injury affected mainly younger age groups and road traffic accidents were the most common cause.
[ABSTRACT]   Full text not available  [PDF]
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Presentation and management of hypopituitarism in Tripoli-Children Hospital 2000-2010
F BenRajab, HR Gajam, T Emahbes
July-December 2017, 2(2):112-119
DOI:10.21502/limuj.014.02.2017  
BACKGROUND: Hypopituitarism refers to complete or partial failure of pituitary hormones secretion that has a wide range of clinical manifestations which require hormone replacement to eliminate or minimize the symptoms and clinical signs of specific hormone deficiencies. We aimed to identify clinical presentation and management of hypopituitarism in pediatric age group. PATIENTS & METHODS: This is a case series study involving 35 patients who were diagnosed to have hypopituitarism due to different causes at Endocrine Clinic of Tripoli-Children Hospital from 2000 to 2010. Data were collected from patient's hard records in the clinic, which include age at presentation, sex, clinical presentation, associated illness, height, weight, extent of pituitary hormone deficiencies, pituitary imaging findings and hormone replacement status. RESULTS: Out of 35 patients 54.3% were males, 45.7% were females with median age at presentation (10±4.5) years. The most common clinical manifestation was short stature (68.6%) followed by hypoglycemia (14.3%) and delayed puberty (8.6%). 11.4% had Craniopharyngioma. MRI showed normal pituitary in 40% of patients, pituitary hypoplasia in 45.7%. Biochemically, growth hormone (GH) deficiency was evident in 82.9%, low TSH in 17.1%, low T4 in 14.3%, low serum cortisol level in 20%, low ACTH in 11.4%, low FSH in 8.6%, and low LH in 5.7%. The result also showed that 5.3% of males had low testosterone level and 18.8% of females had low estrogen level. Hormonal replacement included GH therapy (85.7%), thyroxine (62.9%), cortisol (45.7%) and sex hormone (31.4%). CONCLUSION: Most common clinical presentation of hypopituitarism was short stature. Symptoms of patients with hypopituitarism improved by appropriate hormonal replacement according to their needs.
[ABSTRACT]   Full text not available  [PDF]
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ORIGINAL ARTICLE
New experience in cochlear implantation at Benghazi Medical Center
Agila Al-Barasi, Yosef Hassan S. Abdulkarim
0, 0(0):0-0
DOI:10.4103/LIUJ.LIUJ_15_18  
Aims: Deafness is a pathology that interferes in several aspects of the emotional, psychological, social, and intellectual life. Cochlear implants are electronic devices that allow hearing rehabilitation. This study is carried out to show our experience in cochlear implantation at Benghazi Medical Center, Libya. Patients and Methods: A retrospective descriptive study was performed over 110 patients at the Otorhinolaryngology Department, Benghazi Medical Center, between August 2012 and April 2016. The patients were analyzed according to the age, sex, type of implant inserted, approach, and intraoperative and postoperative complications. Two types of implant devices were used: cochlear and MED-EL. Surgery was done by the same surgical team. Results: Seventy of all patients operated for cochlear implantation were male (63.6%), while forty were female (36.4%). One hundred and four (94.5%) were children and 6 (5.55%) were adults. One hundred (91%) cases were prelingually deaf and 10 (9%) were postlingual deafness. Telemetry showed satisfactory neural response in 107 (97.35) cases. Failure to insert the electrode in 1 (0.9%) case as the cochlea was ossified bilaterally. Extrusion of the receiver took place in 1 (0.9%) case. One (0.9%) patient had extrusion after 2 years; another 1 (0.9%) had wound dehiscence. Despite our few years of experience in cochlear implantation, we have achieved the requirement of our patients. The need for structured services and trained professionals in this type of procedure is clear.
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ORIGINAL RESEARCH ARTICLE
Evaluation of COX-2 expression in renal cell carcinoma and its correlation with clinicopathological factors: a tissue microarray study
G.A.R Ashour, WM Said
July-December 2017, 2(2):140-151
DOI:10.21502/limuj.018.02.2017  
Objectives: This study, aimed to evaluate the expression of COX-2 in renal cell carcinoma, and correlate it with different patient clinicopathological data, emphasizing on the role of COX-2 as a prognostic factor for renal cell carcinoma and to decide which cases more likely benefit from the targeted therapy later on. Patients and Methods: The present series consisted of tissue samples obtained from 47 patients (30 patients were males and 17 were females). All the tumor samples were collected from the Pathology Department, Faculty of Medicine, Alexandria University during the period from July 2009 to November 2010. Archival paraffin-embedded renal cell carcinoma tissue samples were used to prepare tissue microarray blocks for immunohistochemical staining with COX-2 antibody. Marker expression was categorized for statistical analysis then correlated to clinicopathological variables. Results: The histological types was significantly associated with COX-2 expression, with higher expression being more common in papillary and chromophobe renal cell carcinoma, the majority of these two types were in score 1 and 2 while majority of clear cell renal cell carcinoma had score 0 and 1. Conclusion: The association of COX-2 marker was related to the histologic type of tumor; COX-2 expression study might provide prognostic information regarding tumor aggressiveness. These findings suggested a potential impact of COX-2 targeted therapy in the treatment of renal cell carcinoma with overexpressed COX-2 that needs further investigation.
[ABSTRACT]   Full text not available  [PDF]
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Inducible clindamycin resistance among Staphylococcal clinical isolates from Tripoli Central Hospital, Libya
SM Aetrugh, MA Aboshkiwa, KA Tawil, UM Shweref, ME Erhuma, MI Mustafa
July-December 2017, 2(2):128-133
DOI:10.21502/limuj.016.02.2017  
BACKGROUND: The resistance to antimicrobial agents among Staphylococci is an increasing problem. This has led to a renewed interest in the usage of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to treat staphylococcal infections. Clinical failure has been reported due to multiple mechanisms that confer resistance to clindamycin antibiotics. The present study was to investigate the inducible clindamycin resistance among isolates of methicillin resistant Staphylococci by the D-test method. MATERIALS & METHODS: This study was conducted on 218 staphylococcal isolates obtained from different clinical specimens of outpatients and inpatients admitted to Tripoli Central Hospital (TCH), Libya. Methicillin resistance was detected by oxacillin, cefoxitin disc diffusion test (Kirby Bauer method) and confirmed by other biochemical tests. Detection of inducible clindamycin resistance was performed by D-test using erythromycin and clindamycin. RESULTS: Eighty-six out of 218 staphylococcal isolates were resistant to erythromycin,26 (11.9%) isolates were D-test positive indicating inducible (iMLSB) phenotype, 24 (11%) isolates exhibited constitutive (cMLSB) phenotype, while 36 (16.5%) showed true sensitivity to clindamycin indicating (MS) phenotype. The distribution of isolates showing iMLSB phenotype was 12 (19.4%) for methicillin-resistant Staphylococcus aureus (MRSA), 8 (17.0%) for methicillin-resistant coagulase-negative Staphylococci (MRCNS), 6 (6.4%) for methicillin-sensitive Staphylococcus aureus (MSSA) and 0 (0%) for methicillin-sensitive coagulase-negative Staphylococci (MSCNS). CONCLUSION: Higher prevalence of iMLSB phenotype was mainly associated with methicillin-resistant than methicillin-sensitive isolates. We recommend that D-test should be performed to facilitate the appropriate treatment of patients infected with Staphylococci.
[ABSTRACT]   Full text not available  [PDF]
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