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Combined spontaneous pneumothorax, pneumomediastinum, and subcutaneous emphysema in a coronavirus disease-2019 pneumonia patient with previously healthy lungs 冠状病毒病-2019肺炎患者合并自发性气胸、纵隔气肿和皮下肺气肿,既往肺健康
Pub Date : 2020-07-01 DOI: 10.4103/LJMS.LJMS_63_20
Teeba Abbood, E. Habas
Breathlessness was the common presenting symptom, but combined spontaneous–pneumothorax–pneumomediastinum–subcutaneous emphysema (SPPSE) is not known complication of coronavirus disease-2019 (COVID-19) pneumonia. We are report a case of CSPPSE in a male adult with previously healthy lungs infected with COVID-19 pneumonia. On May 16, 2020, he was presented to the Emergency Department of Hamad General Hospital, complaining of fever, leukocytosis, and normal CRP. Chest X-ray showed mild COVID-19-related pneumonia. He was started on the local Qatari-recommended protocol for COVIMD-19. Suddenly, his oxygen saturation was deteriorated and transferred to the medical intensive care unit where he had noninvasive ventilation. Chest X-ray showed right pneumothorax, but there was no evidence of pneumomediastinum or subcutaneous emphysema. On May 30, chest computed tomography was conducted and did not show any evidence of chronic lung diseases that can produce CSPPSE. Finally, on June 13, the patient was labeled as recovered COVID-19 patient. CSPPSE is a complication of COVID-19 pneumonia, even in previously normal lungs.
呼吸困难是常见的症状,但自发性气胸-纵隔气肿-皮下肺气肿合并(SPPSE)并不是冠状病毒病-2019 (COVID-19)肺炎的已知并发症。我们报告一例CSPPSE患者为男性成人,既往肺部健康,感染COVID-19肺炎。2020年5月16日至哈马德总医院急诊科就诊,主诉发热、白细胞增多、CRP正常。胸部x光片显示轻度covid -19相关肺炎。他开始使用卡塔尔当地推荐的covid -19方案。突然,他的血氧饱和度恶化,并被转移到医疗重症监护室,在那里他进行了无创通气。胸部x线显示右侧气胸,但未见纵隔气肿或皮下气肿。5月30日,进行了胸部计算机断层扫描,未显示任何可产生CSPPSE的慢性肺部疾病的证据。最终,在6月13日,该患者被标记为新冠肺炎康复患者。CSPPSE是COVID-19肺炎的并发症,即使在以前正常的肺部也是如此。
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引用次数: 0
Association of serum midkine levels with insulin resistance and obesity in patients with polycystic ovarian syndrome 多囊卵巢综合征患者血清midkine水平与胰岛素抵抗和肥胖的关系
Pub Date : 2020-07-01 DOI: 10.4103/LJMS.LJMS_30_20
Fatma Beyazıt, Fatih Kamış, E. Pek, Y. Beyazıt
Objectives: Polycystic ovarian syndrome (PCOS) is thought to be a subclinical inflammatory state with increased levels of circulating pro-inflammatory cytokines. Midkine is a pleiotropic heparin-binding neurotrophic factor with pro-inflammatory properties, and growing evidence has shown a substantial effect of midkine in inflammation. This study aimed to test whether midkine has a role in PCOS development and its relation to obesity and insulin resistance (IR). Materials and Methods: In this comparative cross-sectional study, 56 women with PCOS and 36 eumenorrheic nonhirsute, age- and body mass index (BMI)-matched women as the control group were recruited. Routine and specific (midkine) laboratory analysis and IR measurements were applied to both the study groups. Results: There were no statistically significant difference between PCOS patients and controls with regard to serum midkine levels (P = 0.412). PCOS patients were further divided into two subgroups according to BMI levels. Serum midkine levels were found to be increased in overweight PCOS patients compared with normal-weight PCOS patients (P = 0.044). Although an increasing trend was observed in respect to serum midkine levels in PCOS women with IR (Homeostatic Model Assessment-IR ≥2.5), this elevation was not statistically significant (P = 0.301). Conclusions: The positive effect of obesity on midkine levels supports the idea that midkine is probably released from adipocyte cells. IR possibly has an important role in this mechanism.
目的:多囊卵巢综合征(PCOS)被认为是一种亚临床炎症状态,循环促炎细胞因子水平升高。Midkine是一种多效性肝素结合神经营养因子,具有促炎特性,越来越多的证据表明Midkine在炎症中的重要作用。本研究旨在探讨midkine是否在多囊卵巢综合征的发生发展中起作用及其与肥胖和胰岛素抵抗(IR)的关系。材料和方法:在这项比较横断面研究中,招募了56名多囊卵巢综合征(PCOS)女性和36名年龄和体重指数(BMI)匹配的绝经期无毛女性作为对照组。对两个研究组进行常规和特异性(midkine)实验室分析和IR测量。结果:PCOS患者与对照组血清midkine水平差异无统计学意义(P = 0.412)。根据BMI水平将PCOS患者进一步分为两个亚组。与正常体重PCOS患者相比,超重PCOS患者血清midkine水平升高(P = 0.044)。虽然PCOS伴IR(稳态模型评估-IR≥2.5)的妇女血清midkine水平有上升趋势,但这种升高无统计学意义(P = 0.301)。结论:肥胖对midkine水平的积极影响支持了midkine可能从脂肪细胞释放的观点。IR可能在这一机制中起重要作用。
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引用次数: 1
Anosmia as a screening tool to detect asymptomatic patients with coronavirus disease 2019 嗅觉缺失作为检测新冠肺炎无症状患者的筛查工具
Pub Date : 2020-07-01 DOI: 10.4103/LJMS.LJMS_50_20
Anis Abobaker
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引用次数: 0
Disseminated geotrichosis in a patient with prolonged neutropenia: A rare case report and literature review 长期中性粒细胞减少患者的播散性地头病:一例罕见病例报告及文献复习
Pub Date : 2020-07-01 DOI: 10.4103/LJMS.LJMS_14_20
A. Nair, Sreethish Sasi, Samar Hashim, M. Al-Maslamani
Disseminated fungemia due to non-Candida yeasts is emerging as an opportunistic infection in hematological malignancies with prolonged neutropenia. Invasive infections by Geotrichum spp. are extremely rare and constitute only about 1% of all non-Candida yeasts. The mortality in such patients is high and is seldom reported in the literature. Here, we describe the case of a middle-aged male with treatment-resistant Hodgkin's lymphoma who developed invasive Geotrichum capitatum infection during his neutropenic phase, with poor response to combination therapy with voriconazole and amphotericin B. He was diagnosed from blood culture but succumbed to death on day 10 of admission in spite of treatment with multiple lines of antifungals. G. capitatum is responsible for fatal fungemia in patients with prolonged neutropenia complicating hematological malignancies. A high index of suspicion is required in this patient group to identify disseminated geotrichosis as delay in treatment worsens mortality.
播散性真菌血症由于非念珠菌酵母菌是一种机会性感染出现在血液恶性肿瘤与延长中性粒细胞减少。土曲菌属的侵袭性感染极为罕见,仅占所有非念珠菌的1%左右。此类患者的死亡率很高,在文献中很少报道。在这里,我们描述了一个患有治疗抵抗性霍奇金淋巴瘤的中年男性患者,他在中性粒细胞减少期发生侵袭性头状地霉感染,对伏立康唑和两性霉素b的联合治疗反应不佳,他通过血液培养被诊断出来,尽管接受了多种抗真菌药物治疗,但在入院第10天死亡。在长期中性粒细胞减少合并血液系统恶性肿瘤的患者中,头盖骨是致命的真菌血症的原因。在这组患者中,需要高度的怀疑指数来确定播散性地根病,因为延迟治疗会加重死亡率。
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引用次数: 1
Coronavirus disease 2019 pandemic: An overview of the event 2019冠状病毒病大流行:事件概述
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_31_20
Bashir Bashir Mohammed
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引用次数: 1
Management of diabetes in patients with coronavirus disease 2019: A practical approach 2019冠状病毒病患者糖尿病的管理:一种实用方法
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_34_20
M. Eledrisi, Abdel-Naser Elzouki
Coronavirus disease 2019 (COVID-19) has emerged as a rapidly transmissible communicable disease around the globe. Diabetes is reported as a common morbidity in patients with COVID-19, has been associated with worse clinical outcomes, and may lead to higher mortality. Because the disease has variable presentations varying from mild respiratory symptoms to pneumonia and respiratory failure, proper care of patients with diabetes in this context should cover both outpatient and inpatient sectors. Outpatient management in acutely ill patients includes frequent home glucose monitoring; holding certain medications including metformin, sodium glucose co-transporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists that may cause unwanted side effects such as dehydration and resulting acute kidney injury; continuation and adjustment of insulin therapy; and patient education on indications to seek medical assistance. Inpatient glucose management of patients admitted with COVID-19 involves holding noninsulin medications, monitoring blood glucose, and starting insulin if glucose levels are not in target. Intravenous insulin is recommended for critically ill patients with uncontrolled glucose. Universal measures should include assurance of continuity of care, adherence to therapy, and self-management education using connected health models and telemedicine. Patients with diabetes are considered a vulnerable group during periods of epidemics, and clear recommendations and pathways are essential to assure patients' safety.
2019冠状病毒病(COVID-19)已成为一种全球快速传播的传染病。据报道,糖尿病是COVID-19患者的常见疾病,与较差的临床结果相关,并可能导致更高的死亡率。由于该病的表现多种多样,从轻微的呼吸道症状到肺炎和呼吸衰竭,在这种情况下,对糖尿病患者的适当护理应包括门诊和住院部门。急性病人的门诊管理包括频繁的家庭血糖监测;持有某些药物,包括二甲双胍、葡萄糖共转运蛋白2抑制剂钠和胰高血糖素样肽-1受体激动剂,可能导致不必要的副作用,如脱水和导致急性肾损伤;胰岛素治疗的继续和调整;对患者进行医疗救助指征的教育。入院的COVID-19患者的住院血糖管理包括持有非胰岛素药物,监测血糖,并在血糖水平未达到目标时开始使用胰岛素。建议对血糖不控制的危重病人静脉注射胰岛素。普遍措施应包括保证护理的连续性、坚持治疗以及利用互联卫生模式和远程医疗进行自我管理教育。糖尿病患者被认为是流行病期间的弱势群体,明确的建议和途径对于确保患者的安全至关重要。
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引用次数: 1
Breast cancer in western part of Libya: Pattern and management (2003-2018) 利比亚西部地区乳腺癌:模式和管理(2003-2018)
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_5_20
E. Gusbi, Nada Elgriw, Shiaa Zalmat, H. Alemam, Sumia Khalil, Mokhtar Gusbi, Miluda Elhamadi, Taha Benyasaad, N. Enattah, A. Elzagheid
Background: Breast cancer is the second most common cancer in the world; the most frequent cancer among women, and leading cause of cancer death in females worldwide. Aim: The aim of the study is to study the pattern and treatment modalities for breast cancer patients who registered in Tripoli University Hospital from 2003 to 2018. Patients and Methods: A retrospective, cross-sectional study was conducted at the Oncology Department of Tripoli University Hospital. A convenience sample of 1000 breast cancer patients from 2003 to 2018 was chosen. Demographic, clinic-pathological characteristics, and treatment modalities data were analyzed by SPSS program version 20. Results: Of 1000 breast cancer patients, there were 984 (98.4%) females and 16 (1.6%) males, mean age was 46.1 ± 11.7 years old, most of them from western region. Majority (64.3%) of female were early age at menarche and 46.2% not breastfed. Positive family history of first degree was 28.8%. The left side presentation was the predominant (60.3%); half of the cases were in Stage II. Invasive ductal carcinoma was diagnosed among 62.5% of the cases and 47% of them were in Grade III. Positive estrogen receptor recorded in 73.8% of cases compared to 69.5% positive progesterone. Furthermore, 76.8% of patients had human epidermal growth factor receptor 2 negative and 78.4% of cases had high Ki-67 level. Regarding management, a combination of surgery, radiation, chemotherapy, and hormonal were provided to 58% of cases, 45.5% of patients who received chemotherapy were treated with FEC regimen. Hormonal therapy was given to 67.7% and tamoxifen is the most drugs used. Conclusions: The frequency is higher among younger age (<50 years), early age at menarche, breastfed less than a year, nearly half presented in late Stage (III, IV), invasive ductal carcinoma is predominant histopathological type, most cases were HER2 negative and high Ki-67 expression. More efforts toward primary prevention and early detection are recommended to reduce locally advanced breast cancer.
背景:乳腺癌是世界上第二常见的癌症;是妇女中最常见的癌症,也是全世界妇女癌症死亡的主要原因。目的:本研究的目的是研究2003年至2018年在的黎波里大学医院登记的乳腺癌患者的模式和治疗方式。患者和方法:在的黎波里大学医院肿瘤科进行了一项回顾性横断面研究。选择了2003年至2018年的1000名乳腺癌患者作为方便样本。人口统计学、临床病理特征和治疗方式数据采用SPSS软件版本20进行分析。结果:1000例乳腺癌患者中,女性984例(98.4%),男性16例(1.6%),平均年龄(46.1±11.7)岁,以西部地区居多。多数(64.3%)女性初潮年龄较早,46.2%未接受母乳喂养。有一级家族史的占28.8%。左侧表现居多(60.3%);一半的病例处于第二阶段。62.5%的病例确诊为浸润性导管癌,其中47%为ⅲ级。雌激素受体阳性占73.8%,孕酮阳性占69.5%。76.8%的患者呈人表皮生长因子受体2阴性,78.4%的患者Ki-67水平较高。在治疗方面,58%的病例采用手术、放疗、化疗和激素联合治疗,45.5%的化疗患者采用FEC方案治疗。激素治疗占67.7%,他莫昔芬是使用最多的药物。结论:低龄(<50岁)、初潮年龄早、母乳喂养不足1年者发生率较高,近半数出现在晚期(III期、IV期),浸润性导管癌以组织病理类型为主,多数为HER2阴性、Ki-67高表达。建议在一级预防和早期发现方面作出更多努力,以减少局部晚期乳腺癌。
{"title":"Breast cancer in western part of Libya: Pattern and management (2003-2018)","authors":"E. Gusbi, Nada Elgriw, Shiaa Zalmat, H. Alemam, Sumia Khalil, Mokhtar Gusbi, Miluda Elhamadi, Taha Benyasaad, N. Enattah, A. Elzagheid","doi":"10.4103/LJMS.LJMS_5_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_5_20","url":null,"abstract":"Background: Breast cancer is the second most common cancer in the world; the most frequent cancer among women, and leading cause of cancer death in females worldwide. Aim: The aim of the study is to study the pattern and treatment modalities for breast cancer patients who registered in Tripoli University Hospital from 2003 to 2018. Patients and Methods: A retrospective, cross-sectional study was conducted at the Oncology Department of Tripoli University Hospital. A convenience sample of 1000 breast cancer patients from 2003 to 2018 was chosen. Demographic, clinic-pathological characteristics, and treatment modalities data were analyzed by SPSS program version 20. Results: Of 1000 breast cancer patients, there were 984 (98.4%) females and 16 (1.6%) males, mean age was 46.1 ± 11.7 years old, most of them from western region. Majority (64.3%) of female were early age at menarche and 46.2% not breastfed. Positive family history of first degree was 28.8%. The left side presentation was the predominant (60.3%); half of the cases were in Stage II. Invasive ductal carcinoma was diagnosed among 62.5% of the cases and 47% of them were in Grade III. Positive estrogen receptor recorded in 73.8% of cases compared to 69.5% positive progesterone. Furthermore, 76.8% of patients had human epidermal growth factor receptor 2 negative and 78.4% of cases had high Ki-67 level. Regarding management, a combination of surgery, radiation, chemotherapy, and hormonal were provided to 58% of cases, 45.5% of patients who received chemotherapy were treated with FEC regimen. Hormonal therapy was given to 67.7% and tamoxifen is the most drugs used. Conclusions: The frequency is higher among younger age (<50 years), early age at menarche, breastfed less than a year, nearly half presented in late Stage (III, IV), invasive ductal carcinoma is predominant histopathological type, most cases were HER2 negative and high Ki-67 expression. More efforts toward primary prevention and early detection are recommended to reduce locally advanced breast cancer.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"12 1","pages":"65 - 71"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87579840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Coronavirus disease 2019: The story so far 2019冠状病毒病:到目前为止的故事
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_33_20
A. Omrani
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged in China in late 2019 and became a global pandemic by March 2020. SARS-CoV-2 is a highly transmissible virus that causes a clinical illness known as Coronavirus Disease 2019. The clinical spectrum ranges from mild respiratory and generalized symptoms to severe pneumonia with multiple organ failure. Overall mortality is high in older patients and those with comorbidities such as obesity and cardiovascular disease. Diagnosis is usually confirmed by polymerase chain reaction on upper or lower airway samples. Clinical management is largely supportive; no specific therapeutic options are currently available. Public health interventions have thus far been centered around social distancing, large-scale testing, and isolation. An unprecedent global effort has been mounted for the rapid development of effective SARS-CoV-2 vaccines. Until such time, further waves of SARS-CoV-2 are likely, if the restrictive control measures are removed.
2019年底,严重急性呼吸系统综合征冠状病毒-2 (SARS-CoV-2)在中国出现,到2020年3月成为全球大流行。SARS-CoV-2是一种高度传染性的病毒,会导致一种被称为2019冠状病毒病的临床疾病。临床范围从轻度呼吸系统和全身性症状到伴有多器官衰竭的严重肺炎。老年患者和有合并症(如肥胖和心血管疾病)的患者的总死亡率很高。诊断通常通过上或下气道样本的聚合酶链反应来证实。临床管理基本上是支持的;目前还没有具体的治疗方案。到目前为止,公共卫生干预措施主要围绕保持社交距离、大规模检测和隔离。为快速开发有效的SARS-CoV-2疫苗,全球开展了前所未有的努力。在此之前,如果取消限制性控制措施,可能会出现更多的SARS-CoV-2浪潮。
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引用次数: 5
Association between pterygium and dry eye among patients in Benghazi, Libya 利比亚班加西病人翼状胬肉和干眼症之间的关系
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_62_19
O. Omran, S. Bukhatwa
Background and Aim: Pterygium is a relatively common condition of the conjunctiva that affects people at different stages of life. Dry eye disease (DED) is a well-known associated morbidity with pterygium. The aim of this study was to investigate the association between pterygium and dry eye among otherwise healthy Libyan people. Methods: A case–control study was conducted on patients attending Al-Keish Polyclinic in Benghazi. Two techniques have been applied individually, in parallel and in series for all of the study participants, Schirmer's test and break-up time (BUT) test. Results: This study included 50 eyes belonged to 35 patients with a median age of 37 (range 26–65) years, and among those, 18 (51.4%) cases (25 eyes) had pterygium and a group of 17 (48.6%) cases (25 eyes) were control. Rates of DED diagnosis were highest using parallel testing (positive results in any of the tests) than with BUT and Schirmer's test individually and lowest using series testing (positive results in both tests). Eyes with pterygium showed obviously and statistically significant higher rates of positive test results. All controls were normal testing with Schirmer's test and hence in series testing. Conclusion: Testing for DED using parallel combined testing (BUT and Schirmer's test) relying on positive result of any of the tests increases sensitivity and may increase the value of the test for screening for dry DED among particular high-risk groups.
背景与目的:翼状胬肉是一种相对常见的结膜疾病,影响着不同生命阶段的人们。干眼病(DED)是翼状胬肉的一种众所周知的相关疾病。本研究的目的是调查翼状胬肉和干眼症在其他健康的利比亚人之间的关系。方法:对在班加西Al-Keish综合医院就诊的患者进行病例对照研究。两种技术分别应用于所有研究参与者,平行和串联,Schirmer测试和分手时间(BUT)测试。结果:本研究纳入35例患者50只眼,中位年龄37岁(26 ~ 65岁),其中翼状胬肉18例(51.4%)(25眼),对照组17例(48.6%)(25眼)。与单独使用BUT和Schirmer试验相比,使用平行试验(任何一项试验均为阳性结果)诊断DED的比率最高,而使用串联试验(两项试验均为阳性结果)诊断DED的比率最低。翼状胬肉的阳性检出率明显增高,具有统计学意义。所有对照均采用Schirmer试验进行正常测试,因此采用串联测试。结论:采用平行联合检测(BUT和Schirmer’s试验)检测DED,依靠任何一种检测的阳性结果增加敏感性,并可能增加该检测在特定高危人群中筛查干性DED的价值。
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引用次数: 1
Chondroma of the nose 鼻软骨瘤
Pub Date : 2020-04-01 DOI: 10.4103/LJMS.LJMS_36_19
S. Swain, J. Mohanty
Chondromas of the head-and-neck area are rare lesions and more rare over the nose. Chondroma is a benign neoplasm of cartilaginous origin. It is rarely seen over the dorsum of the nose. It causes cosmetic deformity of the nose and face if it arises from the nose. The diagnosis is confirmed by histopathological examination. The treatment is complete surgical excision. We report a case of chondroma arising at the dorsum of the nose which is slightly mobile. Computed tomography scan showed a mild enhancing lesion at the dorsum of the nose which was completely excised via transcolumellar route. Considering its rarity at the dorsum over the nose, we reported this solitary chondroma of the nose. Chondromas have to be kept in mind during evaluation of any mass over the nasal dorsum.
头颈部软骨瘤是一种罕见的病变,在鼻子上更为罕见。软骨瘤是一种起源于软骨的良性肿瘤。在鼻背上很少见到。如果它起源于鼻子,它会导致鼻子和面部的美容畸形。经组织病理学检查确诊。治疗方法是完全的手术切除。我们报告一个病例的软骨瘤出现在鼻子的背部,这是轻微的移动。计算机断层扫描显示鼻背轻度强化病变,经经鼻小柱路径完全切除。考虑到其罕见的背部超过鼻子,我们报告这个孤立的软骨瘤的鼻子。软骨瘤必须牢记在评估任何肿块在鼻背。
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引用次数: 1
期刊
Libyan Journal of Medical Sciences
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