Libyan Journal of Medical Sciences最新文献

{"title":"Effectiveness and safety of direct-acting antiviral in hemodialysis patients with chronic hepatitis C: A real clinical experience","authors":"A. Elhaddad, Ahmed Elhassi, Sabah M. Elbarasi, Sahar El Kharraz, Zainab Badr, Mohammed Abdal Jalil, Wael Bohasan, Faiza Bashir, Asma Mahmmed, Abdel-Naser Elzouki","doi":"10.4103/ljms.ljms_43_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_43_22","url":null,"abstract":"Background and Aims: Several clinical studies using direct-acting antivirals (DAAs) in maintenance hemodialysis (MHD) patients with chronic hepatitis C virus (HCV) infection have reported excellent antiviral efficacy and tolerability. Our study aimed to assess both the effectiveness and safety of DAAs in MHD patients complicated with HCV in a “real-life” clinical setting. Materials and Methods: A multicenter retrospective analysis of five dialysis centers included 155 patients of age >18 years with chronic HCV on MHD treated with various DAAs regimens for 12-week duration. The primary endpoint was sustained viral response and the secondary was the frequency of adverse effects (AEs). Results: Among the studied cohort, 96 (61.9%) were males and the mean age was 48.2 ± 12.6 years. Sustained virological response (SVR) was achieved in 153/155 (98.7%) patients. Normalization of liver enzymes was observed in patients with SVR (P < 0.05). None of the patients demonstrated deterioration in renal function. The minor AEs were reported in 12 patients - 8.1%. There were no severe AEs, dropouts, or deaths. Conclusion: DAAs are well tolerated and effective in our MHD patients. Strategies to eradicate HCV from dialysis units should consider DAA as treatment along with the practice of standard precautions to prevent nosocomial HCV infection.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"98 1","pages":"70 - 75"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75047595","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}

{"title":"The incidence and risk factors for barotrauma in COVID-19 in intensive care unit, a single-center retrospective study","authors":"Süleyman Yıldırım, E. Kirmizigul, Huseyin Ucar, O. Ediboğlu, C. Kıraklı","doi":"10.4103/ljms.ljms_41_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_41_22","url":null,"abstract":"Background and Objectives: Coronavirus disease-19 (COVID-19) led to respiratory failure and is sometimes complicated with barotrauma. The knowledge about risk factors for the development of barotrauma is scarce and conflict. We aimed to examine the incidence and risk factors for the development of barotrauma in COVID-19 patients who followed up in the intensive care unit (ICU). Materials and Methods: Patients who admitted to ICU from March 15, 2020, to March 31, 2022 were included in the study and retrospectively screened for barotrauma. Patients with barotrauma at ICU admission were excluded from the study. A multiple regression analysis was performed to determine the risk factors for the development of barotrauma. Results: A total of 1113 patients were included in the study, 676 (60.7%) of them were COVID-19. During the study period, at least one barotrauma event was observed in 96 (8.6%) patients. Barotrauma was more common in patients with COVID-19 than non-COVID-19 patients (10.9% vs. 5%, P = 0.001). Positive pressure ventilation was found as the strongest independent risk factor for the development of barotrauma (odds ratio [OR] = 8.80, confidence intervals [CI], 3.88–19.98, P < 0.001). Steroid use also increased the development of barotrauma (OR = 3.45, CI, 1.78–6.67, P = 0.005). Patients with barotrauma had longer length of ICU stay and higher mortality rate than patients without barotrauma. Conclusion: Patients with COVID-19 have a higher risk for the development of barotrauma. Barotrauma is associated with longer ICU stay and increased mortality. Positive pressure ventilation and steroid use are the independent risk factors for barotrauma.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"45 1","pages":"88 - 93"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84796218","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}

{"title":"Clinical venous thromboembolism in spinal trauma with and without spinal cord injury: A 3-year experience of midlands centre for spinal injuries, Oswestry, UK","authors":"Nabil A. Alageli, A. Osman","doi":"10.4103/ljms.ljms_2_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_2_22","url":null,"abstract":"Background and Aims: This study aimed to determine the incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE) among patients admitted acutely to a regional spinal injury center, following spinal trauma; to compare its occurrence between those with spinal cord injury (SCI) and those without; and to assess the effect of various factors such as age, gender, neurological impairment, and duration of prophylaxis on the incidence observed. Patients and Methods: We retrospectively reviewed the charts of 374 consecutive patients who sustained traumatic spinal injury and were admitted acutely to the Midlands Centre for Spinal Injuries, Oswestry (UK), over a 3-year period. A total of 159 patients had spinal trauma with SCI and 215 were neurologically intact. The majority of these patients were treated nonsurgically and received the same thromboprophylactic regimen started within a median of 2 days postinjury. The incidence of clinical VTE (DVT and PE) was determined and some risk factors were assessed. Ethical approval was obtained through the Audit Office Committee of the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry. Results: Among the neurologically intact group, one patient developed clinical PE (0.5%). Out of 159 patients with SCI, 23 developed clinically evident VTE (14.5%), 15 had DVT (11.9%), 4 had PE (5%), and 4 had both DVT and PE. There was no fatality. Complete SCI lesions were associated with higher incidence of VTE compared to incomplete lesions, 17.6% and 11%, respectively (P < 0.001). There were two peaks of thromboembolic episodes: the first during the first 2 weeks after injury (30% of cases) and the second was after the 8th week postinjury (38% of cases). A higher incidence of VTE was recorded in males than females (14.3% and 7.9%, respectively). Aso, the incidence of VTE is slightly higher in the age group between 40 and 60 years, but these differences were not statistically significant. Conclusions: SCI is associated with high risk of venous thromboembolism, and the risk increases with the severity of cord insult. While spinal column injury is shown to be associated with much lower risk. The risk is reduced with strict adherence to thromboprophylactic regimen which we suggest to continue for at least 12 weeks for SCI patients.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"18 1","pages":"94 - 97"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77117029","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}

{"title":"Anabolic androgenic steroids-induced acute “Tombstone” ST-segment elevation myocardial infarction","authors":"Mohamed M. Baghi, S. Abujalala","doi":"10.4103/ljms.ljms_4_23","DOIUrl":"https://doi.org/10.4103/ljms.ljms_4_23","url":null,"abstract":"Anabolic-androgenic steroids (AAS) are frequently used to treat a wide variety of pathological medical conditions including but not limited to hypogonadism, aplastic anemia, and metastatic breast cancer. Nonetheless, the abuse of AAS continues to rise among professional and recreational athletes despite their deleterious adverse effects. Here, we report a 34-year-old male, with a history of nonmedical use of AAS for 2 months, who had persistent severe retrosternal chest pain. His electrocardiogram was suggestive of acute anteroseptal ST-segment elevation myocardial infarction. He underwent urgent coronary angiography which revealed a thrombotic burden in the left anterior descending artery without underlying atherosclerosis.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"40 1","pages":"98 - 101"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86571521","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}

{"title":"Evaluating quality of anticoagulation management among antiphospholipid syndrome patients: An observational cohort study","authors":"Eman N Alhmoud, H. Elewa, Ahmed Elbardissy, R. Ahmed, Mohammed S. Abdul Gelil, Osama Abdel Samad","doi":"10.4103/ljms.ljms_45_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_45_22","url":null,"abstract":"Context: Vitamin K antagonists (VKA) remain the mainstay of therapy for most nonpregnant patients with thrombotic antiphospholipid syndrome (APS) considering the increased risk of thrombotic events demonstrated in prospective direct oral anticoagulants trials. Little is known, however, about the quality of anticoagulation control among VKA-treated APS patients. Aims: This study aimed to evaluate the quality of anticoagulation control in a cohort of warfarin-treated APS patients in comparison with a control group of non-APS patients. Potential predictors of anticoagulation control were also explored. Subjects and Methods: The quality of anticoagulation control (monitoring and clinical outcomes) was retrospectively evaluated in a group of APS patients and compared to a control of non-APS patients. Results: Compared to non-APS, patients with APS had a significantly lower time in therapeutic range (TTR) (64.6 ± 27.8 vs. 77.3 ± 17.8, 95% confidence interval 5.6–19.8, P ≤ 0.001). A significantly higher proportion of patients in the APS group experienced poor anticoagulation control (TTR <70%) than non-APS patients (52.2% vs. 31.9%, Odds ratio 2.3 [1.4–4.1], P ≤ 0.001). APS patients were more likely to experience extreme supratherapeutic International Normalized Ratio (>4.5) than their counterparts (10.9% vs. 6.1%, P < 0.001). No difference in clinical events was reported. Gender was the only significant predictor of TTR among APS patients, as females experienced significantly lower TTR (Beta coefficient − 13.5, P = 0.05). Conclusions: Compared to general warfarin-treated patients with venous thromboembolism, APS patients were less likely to maintain therapeutic targets. Future studies that incorporate genetic, clinical, and social factors are recommended to fully understand the predictors of anticoagulation quality in this high-risk population.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"1 1","pages":"76 - 82"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72721023","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}

{"title":"Acceptance, hesitancy, and refusal of coronavirus disease 2019 vaccine and associated factors in the population of Libya: A cross-sectional study","authors":"Faisal Ismail, Atiya Farag, Fatmah H Alsharif, A. Albakoush, S. Haq, A. Zorgani","doi":"10.4103/ljms.ljms_34_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_34_22","url":null,"abstract":"Background and Aims: To obtain herd immunity and control the coronavirus disease 2019 (COVID-19) infection, a large proportion of the population must be vaccinated. However, not everyone in Libya believes in the necessity or safety of COVID-19 vaccines. Therefore, understanding the reasons and variables impacting vaccine hesitation in the Libyan population will assist in developing strategies to reduce this hesitation and achieve better vaccination levels in the country. This study aimed to investigate the acceptance, hesitancy, and refusal of the COVID-19 vaccine and the factors that influence COVID-19 vaccine hesitancy and denial in the Libyan population. Methods: A cross-sectional survey using a snowball sampling strategy to collect data was conducted between February and May 2022. Descriptive statistics and the Chi-square test were used for data analysis. Study questionnaires were distributed using social media. Results: The overall COVID-19 vaccine acceptance was 39.7%, vaccine hesitancy was 36.6%, and vaccine refusal was 23.6% among the study participants. The highest refusal rate was among participants aged 12–24 years, 49 out of 91 (53.8%). Vaccine refusal was similar in males and females; however, vaccine acceptance was higher among females than males. Vaccine acceptance was higher in people with a higher graduate degree than those less educated (P = 0001). Conclusion: Our findings show that vaccine hesitancy was 36.6% and vaccine refusal was 23.6% among the study participants. The study identified reasons for vaccine hesitancy and refusal and proposed education programs to address misbeliefs about the COVID-19 vaccine, allowing people to make informed decisions.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"54 1","pages":"83 - 87"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89820241","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}

{"title":"Spurious thrombocytopenia in an automated platelet quantitation: A dilemma with the regular laboratory tasks","authors":"Bashir Bashir Mohammed","doi":"10.4103/ljms.ljms_13_23","DOIUrl":"https://doi.org/10.4103/ljms.ljms_13_23","url":null,"abstract":"Spurious thrombocytopenia is a very rare condition, in which the actual number of platelets circulating in the body is substantially lesser than the number of platelets that automated cell counters record. It is crucial to be aware of this event since spurious thrombocytopenia might result in the incorrect diagnosis of thrombocytopenia, which would then necessitate additional expensive and time-consuming testing in the laboratory and the wrong course of treatment. In this article, actual knowledge of this uncommon event and the clinically significant laboratory will be compiled and reviewed based on the literature that has been published. The pathophysiological and laboratory aspects, important information on the identification and avoidance of false thrombocytopenia, and potential methods for determining the corrected platelet count were discussed.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"7 6 1","pages":"65 - 69"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88239030","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}

{"title":"Endoscopic retrograde cholangiopancreatography findings in HIV cholangiopathy patients: Tripoli Central Hospital experience","authors":"Marwan Alsari, Salah Elfaghih, Ali Tumi","doi":"10.4103/ljms.ljms_35_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_35_22","url":null,"abstract":"HIV infection and its related opportunistic infections increasing the risk of having HIV-related cholangiopathy, especially those who had low CD4 counts. In this case series, we assessed the findings of endoscopic retrograde cholangiopancreatography and the interventions required in those patients who underwent this procedure at Tripoli Central Hospital between January 2007 and December 2020, comparing them with previous studies conducted in other centers. Our study concluded that common bile duct strictures are more frequent finding than papillary stenosis, and accordingly most of those patients managed by placing common bile duct stent rather than sphincterotomy only.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"19 1","pages":"58 - 59"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73995505","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}

{"title":"Outcome of treatment for hepatitis C infection in hemodialysis patients with direct-acting second-generation anti-HCV drugs at Azzawiyah kidney hospital, Libya","authors":"B. Shaibani, K. Ayad, Marwa Melodi, Sabah Albarasi, B. Annajar, M. Jibani","doi":"10.4103/ljms.ljms_39_21","DOIUrl":"https://doi.org/10.4103/ljms.ljms_39_21","url":null,"abstract":"Background: Hepatitis C virus infection is the most common viral infection in patients on hemodialysis and is a leading cause of chronic liver disease in end-stage renal disease patients. The main aim of this study was to review the outcome of the treatment of HCV in hemodialysis patients with second-generation anti-HCV drugs at Azzawiyah Kidney Hospital. Patients and Methods: Thirty-two hemodialysis patients with proven HCV infection (HCV-polymerase chain reaction-positive) received antiviral treatment for 12 weeks and followed up for 12 months, with liver function tests and repeated HCV-RNA. The primary outcome was the proportion of patients who achieved sustained virological response at 12 weeks posttreatment (SVR-12). Results: 32 patients (32/280, 11.4%) out of the total number of (280) regular hemodialysis patients were proven to have HCV infection, during the period from December 2016 to December 2019. The median age of the study population was 53.5 ± 12 years, and 55% were females. The median duration of dialysis was 9.6 years (range 3–25 years). The causes of chronic kidney disease were diabetes mellitus at 43.7%, hypertension at 25.5%, adult polycystic kidney disease at 12.5%, and chronic glomerulonephritis at 9.3%. Twenty nine (29/32) patients received antiviral treatment with sofosbuvir/daclatasvir (SOF/DLC) and ( 3/32) patients with elbasvir and grazoprevir (ERB/GZR). 96.9% of SOF/DLC achieved SVR 12 and 100% of EBR/GSR by the end of the treatment, only one patient ( 3.1 %) failed to achieve it. No significant side effects were reported for the treatment drugs. Conclusion: This study confirmed that the treatment of hemodialysis patients with chronic hepatitis C infection with second-generation anti-HCV drugs is safe and has elicited a sustained negative virological response.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"95 1","pages":"53 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81144501","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}

{"title":"Primary non-Hodgkin lymphoma lung: A report of two cases","authors":"Rabab Mohamed Badri, S. Fatima","doi":"10.4103/ljms.ljms_40_22","DOIUrl":"https://doi.org/10.4103/ljms.ljms_40_22","url":null,"abstract":"Lymphomas are a heterogeneous group of malignancies that originate from the neoplastic transformation of lymphocytes. Primary pulmonary non-Hodgkin lymphoma is a rare entity with marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) which is the most common subtype is a low-grade lymphoma accounting for <0.5% of all primary lung neoplasms. The most common presentation is a mass discovered on a chest radiograph in an asymptomatic patient, with symptomatic patients presenting with cough, dyspnea, chest pain, and hemoptysis. On computerized tomography, multiple bilateral lesions are commonly seen in pulmonary MALT lymphoma with consolidation, nodule, and mass being the main morphological patterns. We present two cases diagnosed with marginal zone lymphoma of the lung which is an indolent lymphoma and the most common subtype in the lung.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"59 1","pages":"60 - 63"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89161650","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}