Tripoli Medical Center

Tripoli, Libya

Tripoli Medical Center

Tripoli, Libya
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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.

Elramalli A.,Tripoli Medical Center | Almshawt N.,University of Tripoli | Ahmed M.O.,University of Tripoli
The Pan African medical journal | Year: 2017

A collection of 94 Gram-negative bacteria isolates, showing different antimicrobial resistance phenotypes including to the carbapenem classes was investigated. Strains were originated form clinical sources from a single hospital in Tripoli, Libya during 2015 and were identified based on cultural and phenotypic characteristics, and fully characterized by the VITEK automated system. Forty-eight percent (48%) of the collection was identified as Acinetobacter baumannii, 50% Klebsiella pneumoniae and 2% Escherichia coli. Resistance to the carbapenem classes was reported in 96% of the A. baumannii strains and 94% of the K. pneumonia strains. Seventy-eight percent (78%) of the isolates showed different multidrug-resistant (MDR) phenotypes, of which K. pneumoniae expressing the highest rates of MDRs(i.e. 91%). Emergence of resistance to carbapenems in the Gram-negative bacteria is a challenging global problem, particularly for Africa. Surveillance of these pathogens and appropriate actions are urgently required in Libyan healthcare settings.

Ahmed M.O.,University of Tripoli | Elramalli A.K.,Tripoli Medical Center | Amri S.G.,Burns and Plastic Surgery Center | Abuzweda A.R.,Biotechnology Research Center | Abouzeed Y.M.,University of Tripoli
Eastern Mediterranean Health Journal | Year: 2012

This is the largest Libyan study to date to investigate the prevalence and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers in Tripoli, Libya. A total of 569 doctors and nurses from 4 main hospitals were screened for MRSA with specimens collected from the anterior nares. Isolates from 109 of the 569 subjects (19%) were confirmed as MRSA by polymerase chain reaction assay; the majority (98/109) were from a general hospital. Antimicrobial resistance patterns tested by disk diffusion were as follows: erythromycin (74%), ciprofloxacin (77%), clindamycin (20%), trimethoprim/sulfamethoxazole (50%), quinuprisin/dalfopristin (19%), vancomycin (12%) and mupirocin (5%). Eighteen isolates exhibited macrolide-lincosamide-streptogramin B resistance (MLSB): 6 were MLSBi and 12 were MLSBc. The results provide evidence that Libyan health care workers could serve as MRSA carriers and play a role in the dissemination of MRSA to the public and other workers.

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.

Lamoshi A.Y.,Tripoli Medical Center | El-Gharmooll B.,Tripoli Medical Center
Annals of Pediatric Surgery | Year: 2015

Aim The aim of the study was to review the current approach to manage ambiguous genitalia caused by CAH. Methods This was a retrospective study of 30 patients with CAH and ambiguous genitalia treated over 10 years. Age at presentation, degree of verilization, preoperative diagnostic studies, operative technique, blood loss, outcome, and follow-up period were the studied variables. Results The older 19 patients underwent single-stage feminizing genitoplasty and the younger 11 patients underwent a multiple-stage procedure. All patients had undergone clitoroplasty, clitoral recession, or resection. Postoperative complications documented in 23% of the patients included atrophy of the clitoris, flaps complication, and vaginal stenosis. The anatomic and cosmetic outcomes were considered good or satisfactory in 70% and 20% of cases, respectively, and poor in 10% of cases. Conclusion One-stage or multiple-stage feminizing genitoplasty gives a high percentage of satisfactory cosmetic outcomes. TUM can be implemented to achieve excellent results for complex genitourinary anomalies. © 2015 Annals of Pediatric Surgery.

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.

A 54-year-old man was referred to our hospital because of a false aneurysm in his right groin following Aortobifemoral and femoropopliteal bypass surgery. He underwent false aneurysm repair and infrainguinal arterial reconstruction. He then developed MRSA sepsis in the right groin. The patient underwent a number of operations to remove the infected grafts and distal revascularization to allow limb salvage. His last operation was an iliofemoral bypass via extra-anatomical route, from just below the iliac crest into the popliteal artery using an 8 mm-ringed polyester gelatin polypropylene tube graft, with complete debridement of a groin infection. Postoperative duplex scan and 3-dimentional CT angiography revealed a patent prosthetic graft and the patient made uneventful postoperative recovery. We conclude that this extra-anatomical bypass is a safe technique and a good option for patients with an infected vascular prosthetic graft in the groin after previous revascularization.

Arifi M.,Tripoli Medical Center
Qatar Medical Journal | Year: 2011

Celiac trunk aneurysm is a rare finding. Most patients are symptomatic at the time of diagnosis but occasionally such aneurysms are detected incidentally during diagnostic imaging for other diseases. Since the anomaly was first described in 1745(1) fewer than 180 cases have been reported in the international medical literature.(2) Atherosclerotic aneurysms of the celiac artery (CAAs) comprise approximately 4-6% of all visceral aneurysms.(3,4) Early surgical intervention has reduced the rupture rate to 7% in recent years.(5) Early recognition and intervention are crucial because the operative mortality rate associated with ruptured celiac artery aneurysms is around 40%.(6) There are no absolute size criteria associated with significant rates of CAA rupture, but 2 cm appears to warrant intervention in most series.(7,8) Surgical reconstruction, surgical ligation, intraluminal embolization, thrombin injection and endovascular grafting have all been reported with success.(9-11) We present a case of a 6.9 cm symptomatic celiac artery aneurysm treated successfully with endovascular stenting.

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.

Daw M.A.,Tripoli Medical Center | Dau A.A.,Tripoli Medical Center
The Scientific World Journal | Year: 2012

Hepatitis C virus has been considered to be one of the most important devastating causes of chronic hepatitis, cirrhosis, and hepatic cellular carcinoma. The prevalence of such virus varies greatly over the world. Arab world has a unique geography and consists over nineteen countries who share the same heritage and customs and do speak the same language. In this area, the epidemiology of hepatitis C is not well understandable. Hepatitis C virus was found to be endemic in Arabia. The serostatus of such virus was found to be variable among these countries with uniform patterns of genotypes. Such prevalence varies tremendously according to the risk factors involved. Blood and blood products, haemodialysis, intravenous, and percutaneous drug users, and occupational, habitual, and social behavior were found to be the important factors involved. Hepatitis C will have major social, economic, and even political burdens on such young and dynamic societies. Thus, strategies and clear policy of intervention are urgently needed to combat the consequences of HCV both regionally and at state level of each country. Copyright © 2012 Mohamed A. Daw and Aghnaya A. Dau.

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