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Tripoli, Libya

Daw M.A.,University of Sfax | Dau A.A.,Tripoli Medical Center
African Journal of Emergency Medicine | Year: 2015

Background: Armed conflicts can negatively affect health services and cause injuries and death. The recent Arab uprising has been associated with considerable damage to infrastructure and loss of human lives. The aim of this study was to determine mortality, injuries and population displacement that occurred during the recent Libyan armed conflict. Methods: A systematic cross-sectional field survey and non-structured search was carried out over fourteen provinces in six Libyan regions, representing the primary sites of the armed conflict between February 2011 and February 2012. Thirty-five percent of the total area of Libya and 62.4% of the Libyan population were involved in the study. The mortality and injury rates were determined and the number of displaced people was calculated during the conflict period. Results: A total of 21,490 (0.5%) persons were killed, 19,700 (0.47%) injured and 435,000 (10.33%) displaced. The overall mortality rate was found to be 5.1 per 1000 per year (95% CI 4.1-7.4) and injury rate was found to be 4.7 per 1000 per year (95% CI 3.9-7.2) but varied by both region and time, reaching peak rates by July-August 2011. Conclusion: The Libyan armed conflict resulted in great human loss and social damage mirrored by high rates of mortality, injury and human displacement. Such parameters peaked as the conflict escalated and differed according to the Libyan regions and provinces involved. National and international efforts should be combined to overcome the consequences of these conflicts. © 2015 African Federation for Emergency Medicine.

Objectives: The purpose of this study was to evaluate the ability of RMI (risk malignancy index) based on menopausal state, CA125,and (ultra sound finding), U/S finding to discriminate a benign from a malignant pelvic mass. Setting: Gynecological oncology unit of obstetrics and Gynecology Tripoli medical center (TMC). Methods: 60 women aged (16-70) years old admitted between (June 2005 - January 2007) ,before primary laprotomy of a pelvic mass preoperative serum CA125 level, U/S findings and menopausal state were done.RMI was calculated for each patient. The Cut-off RMI is 200. The sensitivity, specificity and positive predictive value of serum CA125 level, U/S finding and menopausa(l) status were calculated separately and combined into the RMI, for the diagnosis of ovarian cancer. The histopathological diagnosis was the criteria for the definitive outcome. Results: 42 cases (70%) with pelvic abdominal mass were benign by histopathology, and 18 cases (30%) were malignant.(2) The MRI (magnatic resonase imaging) was more accurate than any individual criteria in diagnosing cancer using RMI cut of level 200 to indicate malignancy. (3) RMI derived from the study gave a sensitivity of 78 %, specificity 95% and positive predictive value of 88%. (4)The best individual performance was found in ultrasound with sensitivity of 72%, specificity of 79% followed by CA125 with sensitivity of 68%, specificity 83%, and menopausal state with sensitivity of 39%, specificity 95%. Conclusion: RMI is able to correctly discriminate between malignant and benign pelvic mass. It is a scoring system which can be introduced easily into the clinical practice to facilitate the selection of patient for primary surgery at oncology unit.

El-Magrahe H.,University of Tripoli | Furarah A.R.,University of Tripoli | El-Figih K.,University of Tripoli | El-Urshfany S.,Tripoli Medical Center | Ghenghesh K.S.,University of Tripoli
Journal of Infection in Developing Countries | Year: 2010

Background: Pregnant women with Hepatitis B virus HBV represent a major reservoir of the virus in the community. Data regarding the prevalence of HBV in pregnant women and maternal transmission of the virus in Libya are lacking. Methodology: Hepatitis blood samples from 1,500 pregnant women and 1,500 cord blood samples of their neonates delivered at Tripoli Medical Center, Tripoli, were tested for HBsAg by ELISA technique. HBsAg-positive samples were also tested for HBeAg. Results: HBsAg was detected in 1.5% (23/1,500) pregnant women and in 0.9% (14/1,500) neonates. Although HBsAg was detected at higher rate in pregnant women aged > 25 years [1.8% (22/1,235)] than in pregnant women aged < 25 years [0.4% (1/265)], the difference was not statistically significant (P > 0.05). All HBsAg-positive neonates were born to HBsAg-positive mothers with a rate of maternal transmission at 0.9% (14/23). HBeAg was detected in 21.7% (5/23) and in 7.1% (1/14) of HBsAg-positive pregnant women and neonates, respectively. Conclusions: Because of the high risk of developing chronic HBV infection at birth among infants born to HBsAg-positive mothers, administration of HBIG in combination with hepatitis B vaccine as post-exposure prophylaxis for such infants is of paramount importance. In addition, universal HBsAg screening of all pregnant women will greatly assist in reducing the maternal transmission of HBV in the country. © 2010 El-Magrahe et al.

Background: Acute upper gastrointestinal bleeding (UGIB) is a common reason for hospital admissions worldwide. Aetiological causes of UGIB vary according to geographic region and socioeconomic status. However, despite the implementation of early endoscopy as the standard method for the diagnosis and treatment of UGIB, data on the characteristics of patients with UGIB in Libya are still minimal. In this study, we describe patient demographics, aetiological causes for UGIB, and possible risk factors for upper gastrointestinal bleeding in patients admitted to the Gastroenterology Department at Tripoli Medical Center from January 2001 through June 2006. Method: This is a retrospective case-series analysis of all adult patients with upper gastrointestinal bleeding admitted to the Gastroenterology Department at TMC. Patients' medical records were individually reviewed and relevant data abstracted. Results: A total of 928 cases with diagnoses of UGIB were admitted to Tripoli Medical Center during the study period. Of these cases, 60.3% were males and 39.7% females (3:2) and males were significantly younger than females (49.6 years vs. 53.9 years, p_0.001). The most common cause of UGIB was peptic ulcer (37.1%) of which duodenal ulcer was the most common (30.7% of all UGIB), especially amongst male patients (36.4%). The second most common cause was bleeding due to varices (29.8%), especially amongst females (35.1%). Additionally, smoking and NSAIDs use were reported by 18.6% and 9.7% of cases and both were significantly associated with bleeding due to peptic ulcers. Conclusion: This study has investigated the characteristics of adults with UGIB at a tertiary referral center in Libya. The high frequency of bleeding due to varices amongst females mandates further investigations into the possible underlying hepatic causes and their management, and the potential impact on patient outcome and prognosis.

Arifi M.,Tripoli Medical Center
Qatar Medical Journal | Year: 2010

An intracardiac hydatid cyst is a rare but potentially very serious complication of hydatid disease as the rupture of the cyst may lead to embolisation of the femoral artery. We report the case of a 29-year-old man who was admitted with the diagnosis of arterial occlusion of the left leg. During surgery, a large hydatid cyst causing femoral artery occlusion was found and excised. This case emphasizes that, in endemic countries, primary vascular echinococcosis should be considered in the differential diagnosis of arterial occlusion.

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