مجلة العلوم الطبية

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A Comparative Evaluation of Stool Microscopy and Coproantigen - ELISA in the Diagnosis of Cryptosporidiosis.
(Sebha University, 2012) Khan A. H, Arkaiya Mohammed Abdul Qader, Yosef Kubti
We evaluated the diagnostic performance of microscopical examination of staining techniques (modified Ziehl – Neelsen and Auramine – Rhodamine) and coproantigen enzyme linked immunosorbent assay (copro-ELISA) for cryptosporidiosis diagnosis. Copro-ELISA appeared to be most sensitive than staining techniques. The commercial copro-ELISA and Auramine - Rhodamine proved to be valuable diagnostic tools for Cryptosporidium infection.
A Dilemma in Anticoagulant Therapy
(Sebha University, 2010) William F Jackson, Charles D Forbes
A Female Van Driver with a Swollen Arm
(Sebha University, 2009) William F Jackson, Charles D Forbes
A Histopathological and Immunohistochemical Study of Traumatic Diffuse Axonal Injury in Albino Rats
(Sebha University, 2007) Kamal Salih M Sayim, Magdy M. Ashmawy
Diffuse axonal injury (DAI) is a frequent result of traumatic deceleration injuries and a frequent cause of persistent vegetative state in patients. DAI is the most significant cause of morbidity in patients with traumatic brain injuries, which most commonly are the result of high-speed motor vehicle accidents. Axonal injury (AI) has been described as a phenomenon which can be induced as a diffuse change, i.e. diffuse axonal injury (DAI) caused by traumatic brain injury. It is only when obvious lesions are absent or minimal; the occult effect of DAI can be invoked. The aim of this study is to evaluate the vitality of the brain and approximately the survival time of rats subjected to sublethal head trauma, using some ordinary and immunohistochemical stains for the injured brains. Sixty adult male albino rats were used in this study, 8 of them were kept as a control group and the others were subjected to sublethal head trauma under light ether anaesthesia. Then they were grouped after exclusion of cases with skull fracture or intracranial hemorrhage, according to their survival time into 4 groups: group I (0—. <30 minutes), group II (0.5 hour—. <2 hours), group III (2 hours—. <4 hours) and group IV (4 hours—. < 6 hours). Sections from different brain areas were prepared with different stains and examined. Gross examination revealed peticheal hemorrhages scattered in all brains, especially brain stem compared to the control group. Microscopic examination pointed to the possibility of detecting the neuronal injury as early as 0.5-2 hours using immunoreactivity against neurone specific enolase (NSE). Also B-amyloid precursor Protein (B-APP) immunoreaction could detect the axonal injury as early as 2-4 hours. Silver stain and H & E stains could reveal these neuronal traumatic changes at later times (4-6 hours). So, immunohistochemical stains are useful to detect neuronal changes for short survivors while ordinary stains are suitable to detect neuronaj changes for victims surviving longer times after trauma. It is to be noted that the diffuse nature of these neuronal injuries is necessary for the diagnosis of traumatic head injury, since ischemic hypoxic insults can lead to localized neuronal changes. So, detection of DAI is helpful in the diagnosis of sudden obscure deaths, especially when occult head trauma is suspected.
Active Versus Traditional Management of Labor: A Prospective Randomized Study
(Sebha University, 2010) N. El-Zanateh, R. El-Gantri,* Emdalala El Ashig M. Gawass, Samira Abodia
Objective: The aim of this study is to explore the effect of active management of labor on the course of labor, prenatal outcomes and the rate of cesarean sections. Sitting: This study was conducted in Tripoli Medical Center from February 2005 to November 2006 and included 300 nulliparous women in spontaneous labor, at term with a singleton fetus in cephalic presentation. Material and Methods: Active phase of labor was defined when labor pains were regular, at least 2 contractions per 10 minutes, each contraction lasts for 45 seconds or more, with cervical dilatation more than 3cm. Cases with multifetal pregnancy, preterm fetus, non cephalic presentation, cervical dilatation >8cm on admission, obvious cephalopelvic disproportion, contracted outlet, fetal congenital anomalies, estimated fetal weight 2500g, spontaneous or induced rupture of membranes before admission, maternal medical disorder with pregnancy, antepartum hemorrhage as well as mother unsure of date, were all excluded. Randomization: Study participants were randomized to active management of labor and traditional management, each group involved 150 participants. Result: A partogram was constructed for each case under the study to compare the prenatal outcome in both groups. The mean duration of labor was less in active management group and cesarean section rate was not significantly different from the other group. Conclusion: Active management does not decrease the cesarean section rate, and is as good as traditional management with respect to prenatal outcome, and it also saves time and effort of the attending physician.
Acute Appendicitis A Prospective Study Of 128 Cases In 2nd March Hospital-Sebha
(Sebha University, 2005) Amer Tawaty, Khalifa M. Alayat, Abdulhafid M. A. Zain Einass. M .Elhudairy
In a prospective study, 128 patients diagnosed as acute appendicitis were admitted to general surgery department of 2nd March hospital.72 were male, 56.25%, with mean age of 24.5 yrs and 56 were female, 43.75%, with mean age 23.5 yrs. Total mean age of 24 yrs range 4-66 yrs. 32 cases are perforated, 25%. 11 cases presented with periappendicular mass, 8.59%. 15 patients operated with normal appendix 12.8%. 7 patients developed wound infection 5.98%, all were perforated.
Acute Gastroenteritis in Misurata Teaching Hospital
(Sebha University, 2009) T. Elgasseir, Anwar
Objectives: To determine the incidence of hospital admission for acute gastroenteritis (AGE) in children below 5 year and to identify factors, that probably, reduce the hospital admission in these cases. Patients and Methods: Descriptive study (Longitudinal hospital based study) during the period of one year in Paediatric Department, Misurata teaching hospital. All hospital admissions, of children under the age of five and older than two month, with clinical symptoms of acute gastroenteritis were included in the study. Before entry to study, clinical assessment of degree of dehydration was performed. Dehydration severity was categorized and treated according to the level of dehydration either mild, moderate, or severe dehydration. The main outcome measures are percent body weight gain at rehydration and at resolution of illness. Results: Based on the results of this study, AGE was estimated at a rate of 11.6% from the total hospital admission (1092) in children below 5 years. 49 patients (38%), 58 patient (46%), and 20 patient (16%) were diagnosed clinically as mild, moderate, and severe dehydration respectively (84% mild-moderate dehydration). In our unit 96 patient (76%) were managed by intravenous fluid. 28 patient (85% from oral rehydration solution [ORS] treatment group) responded to ORS treatment and were discharged without intravenous fluid. Conclusion: It is very clear from our results that ORS can be very effective if appropriately used to patients with mild and moderate dehydration. ORS administered in the observation room or at home with close follow-up will effectively reduce hospital admission.
Acute Intestinal Obstruction in Misurata Central Hospital
(Sebha University, 2009) A. Gaddafi, Faisal Abufalgha, H. Badi N. Abdurrahim
Aim: To identify and analyze the clinical presentation, management and outcome of patients with acute bowel obstruction along with the etiology of obstruction and the incidence and causes of bowel ischemia, and resection. Methods: This is a retrospective observational study of all adult patients admitted with intestinal obstruction to the surgical department in Misurata central hospital in the period of one year, between March 2007 and February 2008. Results: Of the 54 consecutive patients included in the study, the clinical presentations were abdominal pain, abdominal distension, vomiting, constipation and obstipation. Adhesions (50%), obstructed hernias (37%), and large bowel cancer (9%) were the most frequent causes of obstruction. Bowel resection was performed in 15 cases, 5 of them to resect large bowel cancer and 10 of them because of bowel gangrene due to strangulated hernias, adhesions, volvulus and mesenteric embolism. Conclusion: Close and careful clinical evaluation along with proper investigations is essential for decision of management of patients with acute bowel obstruction to avoid serious complications.
Acute Myocardial Infarction in South Libya
(Sebha University, 2005) Mutwakil G. Ahmed, Faraj A. Shenib, Abdulqader M. Sufrani Mohamoud Hussein Milad
Objective: To determine clinical characteristics of patients with acute myocardial infarction. Setting: Intensive Care Unit, 2nd March Teaching Hospital, Sebha, South Libya. Methods: A prospective hospital-based study of patients with acute myocardial infarction in the period from April 2003 to March 2004. Results: A total of 31 patients were admitted with acute myocardial infarction. The majority of patients (74%) were males. Females (26%) were postmenopausal. The mean age was 56.4 years. All patients showed evolutionary changes in ECG tracings. Creatine phosphokinase was raised in 25 patients (80%) and lactic dehydrogenase in 23 patients (74.6%). The cardinal symptom was chest pain (77.5%). Complications included heart failure (33%), shock (29%), arrhythmia (19%) and angina (16%). Ten (32%) patients died in hospital. Conclusion: The study has revealed a high mortality rate due to AMI and calls for improvement of cardiac care by physicians and control of risk factors by public health experts.
Acute Organophosphate Poisoning in Second March Teaching Hospital
(Sebha University, 2008) Mutwakil G. Ahmed, Ali Mohammed Habib-Alla, Omran M. Abdurhman, Abdulqader Elsofrani Almahdi W. Alamin
Objective: To study acute organophosphate (OP) insecticide poisoning. Design: A descriptive prospective observational study. Setting: The intensive care unit (ICU), 2nd March Teaching Hospital, Sebha, South Libya. Patients: Patients with acute poisoning admitted to the ICU from 1st January to 31st December 2006. Clinical data collected included demographic features, history of drug intake, symptoms, signs and laboratory results. Results: One hundred and thirty-six patients were admitted to the ICU with a mean age of 30.4 years. Ninety-two (67.6%) were female. Acute OP poisoning was the leading cause (54.4%), followed by bleach (11%) and scorpion sting (11%). Self-poisoning with OP, in 56 patients (75.7%) was the major factor. One patient (1.35%) died as a result of OP poisoning. Conclusion: Acute OP poisoning is a real medical and social problem that must concern every practicing doctor. In particular self-poisoning which has become a recognized pattern of social behaviour, is a crisis situation which must be treated as such with maximum effort from medical, psychiatric and social welfare services.
Acute Ureteric Calculus Obstruction: Unenhanced Spiral CT Versus MR Urography and Abdominal Radiograph
(Sebha University, 2012) M. Saaid, Emhmed
The main aim of this study was to compare the performance of unenhanced spiral CT to the combination of MR urography (MRU) and plain abdominal radiography (KUB) in patients suspected of having acute calculus ureteric obstruction. 64 patients with suspected acute calculus ureteric obstruction were evaluated. The presence of perirenal fluid, presence and level of ureteric obstruction and calculi were assessed on both techniques. 44 out of 64 (69%) patients had acute calculus ureteric obstruction based on clinical, radiographic or surgical findings. MRU showed perirenal fluid in acute ureteric obstruction (77%) with a greater sensitivity than CT showed stranding (45%). The combination of fluid and ureteric dilation on MRU showed a sensitivity of 93% (CT 80%), specificity of 95% (CT 85%), and accuracy of 94% (CT 81%). KUB showed ureteric calculi in 21/29 (72%) of patients with calculi seen by CT. Overall, MRU/KUB revealed 2.4 abnormalities per acutely obstructed ureter compared with 1.8 abnormalities detected by CT. MRU/KUB using HASTE sequences can diagnose the presence of acute calculus ureteric obstruction with similar accuracy to spiral CT. This technique has less observer variability and is more accurate than CT in detecting evidence of obstruction such as perirenal fluid.
Airway Management in Anesthetized Spontaneosly Breathing Patients: Proseal Versus Classic Laryngeal Mask Airways
(Sebha University, 2010) Aimen A. Houni, Omar A. El-Obidi, Masoud A. Lfeituri, Ahmed Y. Ali, Abdul Mutaleb B. Issa Mohamed M. Gaber, Suheil S. El-Atrash, Ezdin A. Abdraman
Background: Since the development of the classic laryngeal mask airway (cLMA) in 1988, airway management becomes more advanced in recent years. This advancement is demonstrated by the introduction of a wide variety of new alternative airway devices including the ProSeal laryngeal mask airways (PLMA). Aim of the study: To compare the PLMA with the cLMA in anesthetized nonparalyzed adult patients with respect to insertion characteristics, airway sealing pressure (ASP) and incidence of related complications. For the PLMA, we also compared the efficacy of the introducer tool (IT). Methods: Sixty adult patients scheduled for elective minor surgery were categorized into three equal groups; we inserted cLMA in group I, PLMA using the IT in group II, and PLMA with finger insertion technique in group III. Results: The first attempt insertion success rate in group I and II was higher (100%) than in group III (95%). Insertion time (mean ± SD) differed significantly between the groups, and was 8.7 ± (0.92), 13.35 ± (1.66), and 16.95 ± (1.39) seconds in group-I, II and III, respectively. The ASP (cmH2O) was significantly higher in group II (29.15 ± 1.39) and III (28.9 ± 1.17) than in group I (18.35 ± 0.88). The complications encountered were gastric inflation in group I (10%), gagging in all groups (10% in each of group I and II, and 15% in group-III), and in group III, soft tissue injury (5%) and airway obstruction (5%). Conclusion: In anesthetized, spontaneously breathing patients the cLMA is easier and quicker to insert but the PLMA provides a more effective ASP. PLMA insertion using the IT is easier than the finger insertion technique, and causes fewer complications.
Albers – Shonberg Syndrome Oesteapetrosis
(Sebha University, 2002) A. S. Al-Hiti, M. Y. El-Khalifa, Abousaif Ali A. Alsharif Mohamoud Hussein Ali
Amino Acids Profile in Libyan Children with Down's Syndrome
(Sebha University, 2006) Nuri M. Sembesh, Nura Naseb M
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci 1. Isolation and Identification
(Sebha University, 2008) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
The aim of this study was to collect and identify fresh isolates of Gram-positive anaerobic cocci (GPAC) from clinical materials as a basis for the study of taxonomy of GPAC. A total of 116 strains of GPAC, isolated from clinical materials collected from the Department of Microbiology, in St. Lukes Hospital, Guilford and St. Thomas Hospital, London, were investigated. The reference strains were obtained from the American Type Culture Collection (ATCC), Virginia Polytechnic Institute and State University (VPI) and the National Collection of Industrial Bacteria (NCIB). GPAC were identified on the basis of morphology, biochemical examination and the detection of the end products from the fermentation in peptone yeast extract glucose or chopped meat glucose media by means of Gas Liquid Chromatography (GLC). All of the strains studied were obligately anaerobic Gram-positive cocci (GPAC). They occurred in singles, pairs, tetrads, short or long chains. Peptone yeast extract without addition of carbohydrate supported their growth. The strains grew at 37C. The G.L.C. profiles showed that all strains produced acetic acid and lactic acid. One hundred and three (89%) out of 116 isolates were considered to be different from each other at the species level. These were Peptostreptococcus (Pst.) anaerobius (26.7%), Peptococcus (Pc.) magnus (19%), Streptococcus (Str.) asaccharolyticus (6.9%), Peptostreptococcus (Pst.) micros (3.5%), Peptococcus (Pc.) asaccharolyticus (2.6%), Gaffkya (G.) anaerobia (1.7%), and Megosphaera (M.) elsdenni (0.9%). Thirteen (11.1%) out of 116 strains could not be speciated.
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci. 2. Carbohydrate Fermentation
(Sebha University, 2008) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
An attempt was made to classify gram-positive anaerobic cocci (GPAC) on the basis of their production of fatty acids from the fermentation of mannose, galactose and rhamnose by the use of gas liquid chromatography (GLC). The only species that could be separated were Peptostreptococcus (Pst.) anaerobius and Megasphaera (M.) elsdenii. Unfortunately the other species were indistinguishable using information obtained from the GLC analysis.
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci. 3. Antimicrobial Susceptibility Testing
(Sebha University, 2008) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
Antibiotics and dye susceptibility tests have been used by several investigators as selective agents or as presumptive procedures for the identification of anaerobes. In this study a total of 76 strains of Gram-positive anaerobic cocci (GPAC) were tested against five antibiotics (Oleandomycin, Vancomycin, Gentamycin, Tobramycin and Cephradine, and three dyes (Brilliant green, Crystal violet and Gentian violet), using agar plate dilution methods. Although the data of the susceptibility of GPAC to the tested antibiotics and dyes were of no use for the classification of these cocci, it could be concluded that Cephradine and Vancomycin are efficacious antibiotics against GPAC. However, Gentamycin and Tobramycin displayed an activity against Megosphaera (M.) elsdenii and Streptococcus (Str.) intermedius. In addition, Tobramycin was active against Gaffkya (G.) anaerobia, Peptococcus (Pc.) asaccharolyticus, Pc. prevotii and Pc. saccharolyticus, whilst all GPAC were resistant to Oleandomycin.
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci. 4. The Cell Wall Composition
(Sebha University, 2008) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
The classification of Gram-positive anaerobic cocci (GPAC) has always been very unsatisfactory. Attempts to clarify the taxonomy of GPAC have involved several methods including the analysis of the composition of bacterial cell wall. In an attempt to obtain information on the cell walls of 24 strains of GPAC isolated from clinical materials at St. Lukes, Guilford, and St. Thomas Hospital, London, the amino acid and amino sugar composition was quantitatively determined by an amino acid analyzer, using the method of Park and Hancock. The present study has revealed that the evaluation of the cell wall components is an accurate and reproducible method for classification of GPAC. The investigation showed that there are major differences in the amino acid composition of the cell walls of the members of GPAC. On balance, the separation of most GPAC using this system in general is consistent with the principles of Holdman et al (1977) and added valid characteristics for certain organisms such as differentiation of the species of Pst. micros from Pc. magnus, and recognition of the species of Pc. variablis and Pc. anaerobius as a variant species of Pc. magnus. The most unexpected finding was the designated reference strains of Pc. asaccharolytius varied significantly in their cell wall components. Therefore, additional strains must be studied in order to clarify the characterization and hence the nomenclature of such organisms.
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci. 5. The Metabolism of Amino Acid
(Sebha University, 2009) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
This study showed that the metabolism of amino acids was useful in differentiating between the species of Gram-positive anaerobic cocci (GPAC). The best results were obtained from those whose taxonomic positions or biochemical reactions were in doubt. These include Peptococcus ( Pc.) asaccharolyticus, Pc. aerogenes,, Pc. magnus, Pc. anaerobius, Pc. variabilis, Pc. niger and Peptostreptococcus (Pst. micros. For these species which are easily recognized by carbohydrate fermentation amino acid utilization was less discriminatory. It should be noted, however, that the most frequently isolated GPAC from clinical materials are those which have a high capacity to utilize amino acids. This study has revealed that the carbohydrate fermenters are less commonly encountered in clinical specimens. This indicates that the species which are more active against amino-acids are more commonly pathogenic, and this phenomenon should therefore be exploited to identify and classify the GPAC.
An Approach to the Taxonomy of Gram-positive Anaerobic Cocci. 6. The Metabolism of Amino Acids
(Sebha University, 2009) Timothy J. Coleman, Jaber S. Orwa, Mutwakil G. Ahmed
This study showed that the metabolism of amino acids was useful in differentiating between the species of Gram-positive anaerobic cocci (GPAC). The best results were obtained from these whose taxonomic position or biochemical reaction were in doubt. These include Peptococcus ( Pc.) asaccharolyticus, Pc. aerogenes,, Pc. magnus, Pc. anaerobius, Pc. variabilis, Pc. niger and Peptostreptococcus (Pst.) micros. For these species which are easily recognized by carbohydrate fermentation amino acid utilization was less discriminatory. It should be noted, however, that the most frequently isolated GPAC from clinical materials are those which have a high capacity to utilize amino acids. This study has shown this and that the carbohydrate fermenters are less commonly encountered in clinical specimens. This indicates that the species which are more active against amino-acids are more commonly pathogenic, and this phenomenon should therefore be exploited to identify and classify the GPAC.

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