Walid K. Saadawi, Aisha Gashout, Nadia Aldobea, A. Amro, B. Annajar
Urogenital Schistosomiasis is a parasitic worm disease caused by Schistosoma haematobium and transmitted through the penetration of the human skin by swimming infective larva (Cercaria). Here, we report a new sporadic case of Urinary schistosomiasis in Ubari city in South-West Libya. A 25-year-old male was presented with a history of hematuria, backpain, abdominal, and kidney pain since 2017. The diagnosis of urogenital Schistosomiasis was confirmed by microscopic identification of terminal-spined schistosome eggs and red blood cells in urine samples. The patient was treated with a single dose of 40 mg/kg Praziquantel. By follow-up, a complete recovery of urinary symptoms was observed with no evidence of schistosome eggs in urine. In conclusion, the local health authorities should take proper measures to establish new elimination programs of schistosomiasis, and to increased awareness of this especially in old endemic areas where reemerging of schistosomiasis is most likely.
{"title":"Urogenital schistosomiasis in libya, a case report and evaluation of the current situation","authors":"Walid K. Saadawi, Aisha Gashout, Nadia Aldobea, A. Amro, B. Annajar","doi":"10.4103/ljms.ljms_17_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_17_21","url":null,"abstract":"Urogenital Schistosomiasis is a parasitic worm disease caused by Schistosoma haematobium and transmitted through the penetration of the human skin by swimming infective larva (Cercaria). Here, we report a new sporadic case of Urinary schistosomiasis in Ubari city in South-West Libya. A 25-year-old male was presented with a history of hematuria, backpain, abdominal, and kidney pain since 2017. The diagnosis of urogenital Schistosomiasis was confirmed by microscopic identification of terminal-spined schistosome eggs and red blood cells in urine samples. The patient was treated with a single dose of 40 mg/kg Praziquantel. By follow-up, a complete recovery of urinary symptoms was observed with no evidence of schistosome eggs in urine. In conclusion, the local health authorities should take proper measures to establish new elimination programs of schistosomiasis, and to increased awareness of this especially in old endemic areas where reemerging of schistosomiasis is most likely.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"4 1","pages":"93 - 95"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90160409","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}
Madhavi Karri, Balakrishnan Ramasamy, S. Perumal, K. Kannan
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological condition with characteristic clinical and radiological features. PRES occurring as a complication post blood transfusion is reported to be rare, irrespective of the presence of an underlying hematological disorder. Here, we describe a case of a 37-year old female known case of chronic anemia secondary to menorrhagia, who received three units of packed red blood cells transfusion and there was raise in hemoglobin from 6 gm/dl to 11 gm/dl. Four hours after the last transfusion, she developed occipital headache with neck pain and presented to us with two episodes of generalized tonic-clonic seizures after four days of symptoms onset. With this clinical picture in correlation with magnetic rsonance imaging findings, features were consistent with PRES. PRES is contemplated as one of the acute transfusion reactions but a rare entity, which is often preventable.
{"title":"Posterior reversible encephalopathy syndrome: An acute neurological complication of blood transfusion","authors":"Madhavi Karri, Balakrishnan Ramasamy, S. Perumal, K. Kannan","doi":"10.4103/ljms.ljms_89_20","DOIUrl":"https://doi.org/10.4103/ljms.ljms_89_20","url":null,"abstract":"Posterior reversible encephalopathy syndrome (PRES) is an acute neurological condition with characteristic clinical and radiological features. PRES occurring as a complication post blood transfusion is reported to be rare, irrespective of the presence of an underlying hematological disorder. Here, we describe a case of a 37-year old female known case of chronic anemia secondary to menorrhagia, who received three units of packed red blood cells transfusion and there was raise in hemoglobin from 6 gm/dl to 11 gm/dl. Four hours after the last transfusion, she developed occipital headache with neck pain and presented to us with two episodes of generalized tonic-clonic seizures after four days of symptoms onset. With this clinical picture in correlation with magnetic rsonance imaging findings, features were consistent with PRES. PRES is contemplated as one of the acute transfusion reactions but a rare entity, which is often preventable.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"24 1","pages":"90 - 92"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90897422","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}
Background and Aims: Inflammatory bowel disease (IBD) usually follows a pattern of more or less frequent relapses of alterable duration, interspersed with periods of remission. Various clinical predictors have been broadly studied, but the research study populations reported are mostly from Western countries. Methods: From January 2013 to December 2018, 106 new-onset Crohn's disease (CD) patients and 76 new-onset ulcerative colitis (UC) patients were followed up for a median of 12 months or until relapse. The predictors of clinical relapse were analyzed according to demographic, clinical, histological, endoscopic, and imaging variables. Results: In multivariate analysis, predictors of relapse were age of onset <35 years (hazard ratio [HR] = 5.236; 95% confidence interval [CI] 1.252–22.222; P = 0.023) in CD patients and poor medication adherence (HR = 2.070; 95% CI 1.018–4.202; P = 0.044) in UC patients. Conclusion: Younger age of onset and poor medication adherence increases the risk of clinical relapse in CD and UC, respectively.
{"title":"Predictors of clinical relapse in patients with new-onset inflammatory bowel disease: A retrospective single-center study","authors":"Haowen Wu, Delin Tian, Hao Cai, Renjie Gong, K. Kun, Canxia Xu","doi":"10.4103/LJMS.LJMS_106_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_106_20","url":null,"abstract":"Background and Aims: Inflammatory bowel disease (IBD) usually follows a pattern of more or less frequent relapses of alterable duration, interspersed with periods of remission. Various clinical predictors have been broadly studied, but the research study populations reported are mostly from Western countries. Methods: From January 2013 to December 2018, 106 new-onset Crohn's disease (CD) patients and 76 new-onset ulcerative colitis (UC) patients were followed up for a median of 12 months or until relapse. The predictors of clinical relapse were analyzed according to demographic, clinical, histological, endoscopic, and imaging variables. Results: In multivariate analysis, predictors of relapse were age of onset <35 years (hazard ratio [HR] = 5.236; 95% confidence interval [CI] 1.252–22.222; P = 0.023) in CD patients and poor medication adherence (HR = 2.070; 95% CI 1.018–4.202; P = 0.044) in UC patients. Conclusion: Younger age of onset and poor medication adherence increases the risk of clinical relapse in CD and UC, respectively.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"9 1","pages":"42 - 48"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78877344","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}
M. Eljilani, M. Abdusalam, A. Abdalla, Tarek Dalyoum, Sahar Ahmad, I. Alhudiri, A. Elzagheid
Background/Aim: Since the emergence of the severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) pandemic in Wuhan, China, several efforts are being focused on the development of fast and reliable diagnostic molecular tests. Real-time polymerase chain reaction (RT-PCR) based assay on respiratory specimens was recommended by the World Health Organization as the gold standard for early diagnosis of infection spread. Our study aimed to compare the analytical performance of seven commercially available RT-PCR assays. Materials and Methods: A total of 33 nasopharyngeal swabs were analyzed by: Da An, PerkinElmer, Norgen, Prestige, PhoenixDX, Bio-Speedy, and Xpert Xpress RT-PCR assays. Sensitivity and detection rates of SARS-COV-2 target genes were analyzed. Results: Da An and Xpert Xpress assays showed the highest detection rate and percentage for SARS-COV-2 target genes; (16/33) 48.5%, followed by PerkinElmer and Norgen kits (13/33) 39.4%, (10/33) 30.3%, respectively. However, Prestige, PhoenixDx, and Bio-speedy displayed the same performance (6/33) 18.2%. Conclusion: The analyzed assays showed inconsistent analytical performance. Overall, findings reported in our study may not be applicable to other RT-PCR assays or thermocyclers; analytical sensitivities and positive-negative cut-off values should be locally validated.
{"title":"Performance evaluation of seven commercial real-time polymerase chain reaction assays for SARS-COV-2 detection","authors":"M. Eljilani, M. Abdusalam, A. Abdalla, Tarek Dalyoum, Sahar Ahmad, I. Alhudiri, A. Elzagheid","doi":"10.4103/ljms.ljms_5_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_5_21","url":null,"abstract":"Background/Aim: Since the emergence of the severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) pandemic in Wuhan, China, several efforts are being focused on the development of fast and reliable diagnostic molecular tests. Real-time polymerase chain reaction (RT-PCR) based assay on respiratory specimens was recommended by the World Health Organization as the gold standard for early diagnosis of infection spread. Our study aimed to compare the analytical performance of seven commercially available RT-PCR assays. Materials and Methods: A total of 33 nasopharyngeal swabs were analyzed by: Da An, PerkinElmer, Norgen, Prestige, PhoenixDX, Bio-Speedy, and Xpert Xpress RT-PCR assays. Sensitivity and detection rates of SARS-COV-2 target genes were analyzed. Results: Da An and Xpert Xpress assays showed the highest detection rate and percentage for SARS-COV-2 target genes; (16/33) 48.5%, followed by PerkinElmer and Norgen kits (13/33) 39.4%, (10/33) 30.3%, respectively. However, Prestige, PhoenixDx, and Bio-speedy displayed the same performance (6/33) 18.2%. Conclusion: The analyzed assays showed inconsistent analytical performance. Overall, findings reported in our study may not be applicable to other RT-PCR assays or thermocyclers; analytical sensitivities and positive-negative cut-off values should be locally validated.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"985 1","pages":"56 - 60"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85654640","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}
Background and Aims: Hereditary hemochromatosis (HH) is an autosomal recessive disorder, characterized by increased intestinal absorption of iron. Excessive amount of iron accumulates in the liver, pancreas, and heart, etc., and eventually leading to organ failure due to iron toxicity and death if untreated. The most common causes of HH are the C282Y and H63D mutations in HFE gene. This study aimed to identify the prevalence of H63D and C282Y alleles among the Libyan population in Tripoli region and to compare the results with other published data. Materials and Methods: This study included 300 randomly selected unrelated Libyan male blood donors, aged between 18 and 50 years. In-house hydrolysis probe real-time polymerase chain reaction and high-resolution melting analysis protocols were developed and employed as screening tools for H63D and C282Y genotyping, respectively, and direct DNA sequencing was used to confirm the results. Results: Seven subjects (2.33%) were detected as homozygous H63D mutation and 72 (24%) were detected as heterozygous, and only one subject was detected as a heterozygous C282Y mutant (0.33%) and no homozygous C282Y mutation was detected. Conclusion: In Libyans residing in Tripoli region, the allele frequency of C282Y was very rare and allele frequency of H63D was common.
{"title":"Prevalence of H63D and C282Y mutations in hereditary hemochromatosis (HFE) gene in Tripoli region of Libya","authors":"Laila Elghawi, K. Mahanna, A. Bashein","doi":"10.4103/ljms.ljms_27_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_27_21","url":null,"abstract":"Background and Aims: Hereditary hemochromatosis (HH) is an autosomal recessive disorder, characterized by increased intestinal absorption of iron. Excessive amount of iron accumulates in the liver, pancreas, and heart, etc., and eventually leading to organ failure due to iron toxicity and death if untreated. The most common causes of HH are the C282Y and H63D mutations in HFE gene. This study aimed to identify the prevalence of H63D and C282Y alleles among the Libyan population in Tripoli region and to compare the results with other published data. Materials and Methods: This study included 300 randomly selected unrelated Libyan male blood donors, aged between 18 and 50 years. In-house hydrolysis probe real-time polymerase chain reaction and high-resolution melting analysis protocols were developed and employed as screening tools for H63D and C282Y genotyping, respectively, and direct DNA sequencing was used to confirm the results. Results: Seven subjects (2.33%) were detected as homozygous H63D mutation and 72 (24%) were detected as heterozygous, and only one subject was detected as a heterozygous C282Y mutant (0.33%) and no homozygous C282Y mutation was detected. Conclusion: In Libyans residing in Tripoli region, the allele frequency of C282Y was very rare and allele frequency of H63D was common.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"33 1","pages":"49 - 55"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75709402","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}
R. Julario, Eka Prasetya Budi Mulia, I. Dewi, R. Gunadi, B. Dharmadjati
Background: This study aimed to evaluate the clinical indications and arrhythmic patterns in cardiovascular disease patients who were referred for Holter electrocardiography (ECG) in Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: A retrospective cross-sectional study was held at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Patient's data, including Holter ECG, was obtained from the local Holter Registry between July 2019 and December 2019. Results: A total of 89 patients were included in this study. The mean age was 50.1 ± 16.0 years old, and 48 patients (53.9%) were females. The most common indication was palpitation (39.3%) followed by the history of arrhythmia (14.6%), shortness of breath (13.5%), and chest pain (12.4%). Ventricular ectopic (VE) and supraventricular ectopic (SVE) were the most common arrhythmia in 70.8% and 12.4% of subjects, respectively. About 20.2% of patients had frequent VE, and Lown's Grade 4 was the most prevalent VE accounting for 45.9% of patients among all VE events. A total of 5.6% of patients had episodes of atrial fibrillation. Frequent SVE was found in 4.5% of patients, whereas 5.6% had supraventricular tachycardia. About 3.4% of patients had abnormal atrioventricular conduction, and 4.5% had chronotropic incompetence. Conclusions: Palpitation of unknown etiology was the most common clinical indication for Holter ECG among our patients. The most prevalent arrhythmias were VEs and SVEs, with Lown's Grade 4 being the most prevalent VEs. Holter ECG in patients with that indication was reasonably high diagnostic yield in detecting arrhythmia.
{"title":"Clinical indications and arrhythmic patterns of 24-h holter electrocardiography among cardiovascular disease patients","authors":"R. Julario, Eka Prasetya Budi Mulia, I. Dewi, R. Gunadi, B. Dharmadjati","doi":"10.4103/ljms.ljms_11_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_11_21","url":null,"abstract":"Background: This study aimed to evaluate the clinical indications and arrhythmic patterns in cardiovascular disease patients who were referred for Holter electrocardiography (ECG) in Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: A retrospective cross-sectional study was held at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Patient's data, including Holter ECG, was obtained from the local Holter Registry between July 2019 and December 2019. Results: A total of 89 patients were included in this study. The mean age was 50.1 ± 16.0 years old, and 48 patients (53.9%) were females. The most common indication was palpitation (39.3%) followed by the history of arrhythmia (14.6%), shortness of breath (13.5%), and chest pain (12.4%). Ventricular ectopic (VE) and supraventricular ectopic (SVE) were the most common arrhythmia in 70.8% and 12.4% of subjects, respectively. About 20.2% of patients had frequent VE, and Lown's Grade 4 was the most prevalent VE accounting for 45.9% of patients among all VE events. A total of 5.6% of patients had episodes of atrial fibrillation. Frequent SVE was found in 4.5% of patients, whereas 5.6% had supraventricular tachycardia. About 3.4% of patients had abnormal atrioventricular conduction, and 4.5% had chronotropic incompetence. Conclusions: Palpitation of unknown etiology was the most common clinical indication for Holter ECG among our patients. The most prevalent arrhythmias were VEs and SVEs, with Lown's Grade 4 being the most prevalent VEs. Holter ECG in patients with that indication was reasonably high diagnostic yield in detecting arrhythmia.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"225 1","pages":"61 - 65"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80118727","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}
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, discovered in December 2019 in China is now a pandemic affecting >200 countries worldwide. The general population is susceptible to infection, however elderly people and those with a background of chronic medical illnesses are at increased risk for severe symptoms and complicated outcomes. The SARS-CoV-2 virus usually establishes itself and replicates in the respiratory system and can establish infection in the upper part of the respiratory tract as well as the lower part of the respiratory tract, presenting in a spectrum ranging from asymptomatic infection reaching up to severe acute respiratory distress syndrome,; however, SARS-CoV-2 infection can affect other systems of the human body as many cases have been reported where the patients present with different bodily system symptoms without having respiratory symptoms as usual. We report a case of a 44-year-old male patient who had a psoriasis flare-up and new-onset psoriatic arthritis likely induced by SARS-CoV-2 infection.
{"title":"Psoriasis flare-up and new-onset psoriatic arthritis induced by severe acute respiratory syndrome coronavirus 2 infection","authors":"Mohammad N. Kloub, Mousa Alhiyari, M. Yassin","doi":"10.4103/LJMS.LJMS_98_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_98_20","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, discovered in December 2019 in China is now a pandemic affecting >200 countries worldwide. The general population is susceptible to infection, however elderly people and those with a background of chronic medical illnesses are at increased risk for severe symptoms and complicated outcomes. The SARS-CoV-2 virus usually establishes itself and replicates in the respiratory system and can establish infection in the upper part of the respiratory tract as well as the lower part of the respiratory tract, presenting in a spectrum ranging from asymptomatic infection reaching up to severe acute respiratory distress syndrome,; however, SARS-CoV-2 infection can affect other systems of the human body as many cases have been reported where the patients present with different bodily system symptoms without having respiratory symptoms as usual. We report a case of a 44-year-old male patient who had a psoriasis flare-up and new-onset psoriatic arthritis likely induced by SARS-CoV-2 infection.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"3 1","pages":"96 - 99"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91055487","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}
Pub Date : 2021-04-01DOI: 10.4103/LJMS.LJMS_107_20
Mohamed M. Elmusbahi, J. Kloppers
Background: The most common investigations used in the preoperative diagnosis of choledocholithiasis are ultrasound and liver function tests (LFTs). These modalities have a low sensitivity for detecting common bile duct stones among the intermediate-risk groups. Aim: The aim of the study is to identify preoperative findings which predict choledocholithiasis in intermediate-risk groups. Describe the implications of a positive intraoperative cholangiogram (IOC). Materials and Methods: A retrospective study of all consecutive laparoscopic cholecystectomies with IOC performed. Data were collected over the past 2 years between January 1, 2015, and December 31, 2016. Standard demographic variables, preoperative symptoms, LFTs, IOC findings, abdomen ultrasound, and postoperative symptoms were included in the study. Results: Of 237 laparoscopic cholecystectomies 23 cases were planned for IOC. The median age was 41 years. Seventeen cases were female. Indications were 12 biliary colic, eight gallstone pancreatitis, two cases of acute cholecystitis, and one case was for ascending cholangitis. Four cases had a positive IOC, and in this group, the median age was 44.5 years with one male. The mean common bile duct diameter was 6.5 mm. Two patients had biliary colic, one patient gallstone pancreatitis, and one acute cholecystitis. One patient had a history of jaundice, and all four cases had elevated gamma-glutamyl transferase (GGT) above 40 mmol/l, three cases had alkaline phosphatase (ALP) above 98 mmol/l. Postoperative, out of 23 cases, five cases had an endoscopic retrograde cholangiopancreaticogram, repeated ultrasound in three cases, persistence symptoms in four cases. Conclusions: GGT was the strongest predictor of choledocholithiasis. A normal GGT seems to be quite good at ruling out Cannabidiol stones. ALP was less accurate. Gallstone pancreatitis is not a good predictor, but it is importance to exclude choledocholithiasis before/during cholecystectomy. There is no relation between the IOC and persistent symptoms.
{"title":"Which preoperative findings translate to a positive intraoperative cholangiogram?","authors":"Mohamed M. Elmusbahi, J. Kloppers","doi":"10.4103/LJMS.LJMS_107_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_107_20","url":null,"abstract":"Background: The most common investigations used in the preoperative diagnosis of choledocholithiasis are ultrasound and liver function tests (LFTs). These modalities have a low sensitivity for detecting common bile duct stones among the intermediate-risk groups. Aim: The aim of the study is to identify preoperative findings which predict choledocholithiasis in intermediate-risk groups. Describe the implications of a positive intraoperative cholangiogram (IOC). Materials and Methods: A retrospective study of all consecutive laparoscopic cholecystectomies with IOC performed. Data were collected over the past 2 years between January 1, 2015, and December 31, 2016. Standard demographic variables, preoperative symptoms, LFTs, IOC findings, abdomen ultrasound, and postoperative symptoms were included in the study. Results: Of 237 laparoscopic cholecystectomies 23 cases were planned for IOC. The median age was 41 years. Seventeen cases were female. Indications were 12 biliary colic, eight gallstone pancreatitis, two cases of acute cholecystitis, and one case was for ascending cholangitis. Four cases had a positive IOC, and in this group, the median age was 44.5 years with one male. The mean common bile duct diameter was 6.5 mm. Two patients had biliary colic, one patient gallstone pancreatitis, and one acute cholecystitis. One patient had a history of jaundice, and all four cases had elevated gamma-glutamyl transferase (GGT) above 40 mmol/l, three cases had alkaline phosphatase (ALP) above 98 mmol/l. Postoperative, out of 23 cases, five cases had an endoscopic retrograde cholangiopancreaticogram, repeated ultrasound in three cases, persistence symptoms in four cases. Conclusions: GGT was the strongest predictor of choledocholithiasis. A normal GGT seems to be quite good at ruling out Cannabidiol stones. ALP was less accurate. Gallstone pancreatitis is not a good predictor, but it is importance to exclude choledocholithiasis before/during cholecystectomy. There is no relation between the IOC and persistent symptoms.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"26 1","pages":"83 - 86"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76123765","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}
Aim: The aim of this study is to investigate the etiology of infertility in couples seeking medical help from the Infertility Clinics and gynecological departments in hospitals in Western Libya. Patients and Methods: Data were collected directly from patients' medical records. However, additional data were collected through interviews. Results: The total number of couples recruited was 135. Men (mean ± standard deviation of age = 41.7 ± 7.0 years) were significantly older than women (35.2 ± 6.5 years) (P = 0.001). Women were more likely to marry younger than men (mean difference = 6.5 years, 95% confidence interval [CI] =5.1–7.8 years) and the duration of all participant's marriages before the interviews was 9.0 ± 5.0 years. The causes of fertility were as follows: 33 (24.4%) (95% CI 17.16–31.64) cases were due to a female factor, 92 (68.1%) (95% CI = 60.24–75.96) cases were due to a male factor with 6 (4.4%) (95% CI 0.94–7.86) cases of combined male and female factor and 4 (3%) (95% CI = 0.12–5.88) cases without explained cause. Out of all patients, only 13 (4.8%) (95% CI = 2.25–7.35) were cases of secondary infertility and 257 (95.2%) (95% CI = 92.65–97.75) were cases of primary infertility. In females, the most common causes of infertility were ovulation disorders with 40 (23.4%) (95% CI = 17.05%–29.75%), polycystic ovary syndrome with 23 (13.5%) (95% CI = 8.38%–18.62%), irregular or no menstruation with 19 (11.1%) (95% CI = 6.39%–15.81%). The most frequent findings in males were 76 cases (31.0%) (95% CI = 25.21%–36.79%) asthenospermia, 75 cases (30.6%) (95% CI = 24.83%–36.37%) showing teratospermia and 56 (22.9%) (95% CI = 17.64%–28.16%) with oligospermia. Conclusions: Infertility due to male factor in Libya (approximately 70%), was very high compared to data from other regions of the world. Infertility due to the female factor is comparable to other regions of the world. The main cause for female factor infertility was ovulation disorders. Further research of infertility in other parts of the Middle Eastern and North African region is needed. This research must combine epidemiological, medical, and social investigations to find the main causes of infertility in the region.
目的:本研究的目的是调查在利比亚西部医院不孕不育诊所和妇科寻求医疗帮助的夫妇不孕不育的病因。患者和方法:数据直接从患者病历中收集。然而，通过访谈收集了额外的数据。结果:共招募了135对夫妇。男性(年龄平均±标准差= 41.7±7.0岁)明显大于女性(35.2±6.5岁)(P = 0.001)。女性比男性更倾向于年轻结婚(平均差异为6.5年，95%可信区间[CI] = 5.1-7.8年)，受访前所有参与者的婚姻持续时间为9.0±5.0年。不孕原因:女性因素33例(24.4%)(95% CI 17.16 ~ 31.64)，男性因素92例(68.1%)(95% CI = 60.24 ~ 75.96)，男女联合因素6例(4.4%)(95% CI 0.94 ~ 7.86)，原因不明4例(3%)(95% CI = 0.12 ~ 5.88)。在所有患者中，只有13例(4.8%)(95% CI = 2.25-7.35)为继发性不孕，257例(95.2%)(95% CI = 92.65-97.75)为原发性不孕。在女性中，最常见的不孕原因是排卵障碍40例(23.4%)(95% CI = 17.05% ~ 29.75%)，多囊卵巢综合征23例(13.5%)(95% CI = 8.38% ~ 18.62%)，月经不调或无月经19例(11.1%)(95% CI = 6.39% ~ 15.81%)。男性多见于弱精子症76例(31.0%)(95% CI = 25.21% ~ 36.79%)，异精症75例(30.6%)(95% CI = 24.83% ~ 36.37%)，少精子症56例(22.9%)(95% CI = 17.64% ~ 28.16%)。结论:与世界其他地区的数据相比，利比亚男性因素导致的不孕症(约70%)非常高。由于女性因素导致的不孕症与世界其他地区相当。女性因素不孕的主要原因是排卵障碍。需要进一步研究中东和北非地区其他地区的不孕症。这项研究必须结合流行病学、医学和社会调查，以找出该地区不孕症的主要原因。
{"title":"The etiology of infertility in the western region of Libya: An investigation of medical records","authors":"A. Eldib, O. Tashani","doi":"10.4103/ljms.ljms_21_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_21_21","url":null,"abstract":"Aim: The aim of this study is to investigate the etiology of infertility in couples seeking medical help from the Infertility Clinics and gynecological departments in hospitals in Western Libya. Patients and Methods: Data were collected directly from patients' medical records. However, additional data were collected through interviews. Results: The total number of couples recruited was 135. Men (mean ± standard deviation of age = 41.7 ± 7.0 years) were significantly older than women (35.2 ± 6.5 years) (P = 0.001). Women were more likely to marry younger than men (mean difference = 6.5 years, 95% confidence interval [CI] =5.1–7.8 years) and the duration of all participant's marriages before the interviews was 9.0 ± 5.0 years. The causes of fertility were as follows: 33 (24.4%) (95% CI 17.16–31.64) cases were due to a female factor, 92 (68.1%) (95% CI = 60.24–75.96) cases were due to a male factor with 6 (4.4%) (95% CI 0.94–7.86) cases of combined male and female factor and 4 (3%) (95% CI = 0.12–5.88) cases without explained cause. Out of all patients, only 13 (4.8%) (95% CI = 2.25–7.35) were cases of secondary infertility and 257 (95.2%) (95% CI = 92.65–97.75) were cases of primary infertility. In females, the most common causes of infertility were ovulation disorders with 40 (23.4%) (95% CI = 17.05%–29.75%), polycystic ovary syndrome with 23 (13.5%) (95% CI = 8.38%–18.62%), irregular or no menstruation with 19 (11.1%) (95% CI = 6.39%–15.81%). The most frequent findings in males were 76 cases (31.0%) (95% CI = 25.21%–36.79%) asthenospermia, 75 cases (30.6%) (95% CI = 24.83%–36.37%) showing teratospermia and 56 (22.9%) (95% CI = 17.64%–28.16%) with oligospermia. Conclusions: Infertility due to male factor in Libya (approximately 70%), was very high compared to data from other regions of the world. Infertility due to the female factor is comparable to other regions of the world. The main cause for female factor infertility was ovulation disorders. Further research of infertility in other parts of the Middle Eastern and North African region is needed. This research must combine epidemiological, medical, and social investigations to find the main causes of infertility in the region.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"6 1","pages":"70 - 74"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79201385","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}
Abdelmonem B. Yousif, Ebtihal B. Hassan, M. Ahmed, Mona Lashin, Neathu Kunjumon, T. Sulaiman, Maram Saliba, A. Shier, Mona Babikir, Walaa A. H. Saeed, A. Farghaly, F. Khan
Background: Statins are well tolerated but associated with various statin-associated symptoms, including statin-associated rhabdomyolysis. Objectives: The aim of this study was to evaluate the frequency of rhabdomyolysis in patients treated with various statins and to describe their clinical features and outcomes in our local setting. Patients and Methods: This retrospective cross-sectional study was conducted at Hamad General Hospital and included all patients who received statins for the period between January 1, 2017, and November 31, 2017. Results: Out of 1000 cases involved in this study, 3 cases (0.3%) met the criteria for rhabdomyolysis. Two of them were males and the third was a female. Two cases received simvastatin and one case received rosuvastatin. All developed muscle pain and were hospitalized, during which all patients were treated with drug withdrawal and hydration. Upon discharge, rosuvastatin was replaced by atorvastatin, while simvastatins were replaced by atorvastatin and rosuvastatin. Conclusion: Rhabdomyolysis is a recognized but rare side effect of statins that should not be a reason to limit the use of life-saving statin therapy.
{"title":"Frequency of rhabdomyolysis in patients treated with statins in hamad general hospital, Qatar","authors":"Abdelmonem B. Yousif, Ebtihal B. Hassan, M. Ahmed, Mona Lashin, Neathu Kunjumon, T. Sulaiman, Maram Saliba, A. Shier, Mona Babikir, Walaa A. H. Saeed, A. Farghaly, F. Khan","doi":"10.4103/ljms.ljms_13_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_13_21","url":null,"abstract":"Background: Statins are well tolerated but associated with various statin-associated symptoms, including statin-associated rhabdomyolysis. Objectives: The aim of this study was to evaluate the frequency of rhabdomyolysis in patients treated with various statins and to describe their clinical features and outcomes in our local setting. Patients and Methods: This retrospective cross-sectional study was conducted at Hamad General Hospital and included all patients who received statins for the period between January 1, 2017, and November 31, 2017. Results: Out of 1000 cases involved in this study, 3 cases (0.3%) met the criteria for rhabdomyolysis. Two of them were males and the third was a female. Two cases received simvastatin and one case received rosuvastatin. All developed muscle pain and were hospitalized, during which all patients were treated with drug withdrawal and hydration. Upon discharge, rosuvastatin was replaced by atorvastatin, while simvastatins were replaced by atorvastatin and rosuvastatin. Conclusion: Rhabdomyolysis is a recognized but rare side effect of statins that should not be a reason to limit the use of life-saving statin therapy.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"15 1","pages":"75 - 78"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78275697","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：