{"title":"Association of serum midkine levels with insulin resistance and obesity in patients with polycystic ovarian syndrome","authors":"Fatma Beyazıt, Fatih Kamış, E. Pek, Y. Beyazıt","doi":"10.4103/LJMS.LJMS_30_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_30_20","url":null,"abstract":"Objectives: Polycystic ovarian syndrome (PCOS) is thought to be a subclinical inflammatory state with increased levels of circulating pro-inflammatory cytokines. Midkine is a pleiotropic heparin-binding neurotrophic factor with pro-inflammatory properties, and growing evidence has shown a substantial effect of midkine in inflammation. This study aimed to test whether midkine has a role in PCOS development and its relation to obesity and insulin resistance (IR). Materials and Methods: In this comparative cross-sectional study, 56 women with PCOS and 36 eumenorrheic nonhirsute, age- and body mass index (BMI)-matched women as the control group were recruited. Routine and specific (midkine) laboratory analysis and IR measurements were applied to both the study groups. Results: There were no statistically significant difference between PCOS patients and controls with regard to serum midkine levels (P = 0.412). PCOS patients were further divided into two subgroups according to BMI levels. Serum midkine levels were found to be increased in overweight PCOS patients compared with normal-weight PCOS patients (P = 0.044). Although an increasing trend was observed in respect to serum midkine levels in PCOS women with IR (Homeostatic Model Assessment-IR ≥2.5), this elevation was not statistically significant (P = 0.301). Conclusions: The positive effect of obesity on midkine levels supports the idea that midkine is probably released from adipocyte cells. IR possibly has an important role in this mechanism.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"42 1","pages":"120 - 124"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78416605","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":"Combined spontaneous pneumothorax, pneumomediastinum, and subcutaneous emphysema in a coronavirus disease-2019 pneumonia patient with previously healthy lungs","authors":"Teeba Abbood, E. Habas","doi":"10.4103/LJMS.LJMS_63_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_63_20","url":null,"abstract":"Breathlessness was the common presenting symptom, but combined spontaneous–pneumothorax–pneumomediastinum–subcutaneous emphysema (SPPSE) is not known complication of coronavirus disease-2019 (COVID-19) pneumonia. We are report a case of CSPPSE in a male adult with previously healthy lungs infected with COVID-19 pneumonia. On May 16, 2020, he was presented to the Emergency Department of Hamad General Hospital, complaining of fever, leukocytosis, and normal CRP. Chest X-ray showed mild COVID-19-related pneumonia. He was started on the local Qatari-recommended protocol for COVIMD-19. Suddenly, his oxygen saturation was deteriorated and transferred to the medical intensive care unit where he had noninvasive ventilation. Chest X-ray showed right pneumothorax, but there was no evidence of pneumomediastinum or subcutaneous emphysema. On May 30, chest computed tomography was conducted and did not show any evidence of chronic lung diseases that can produce CSPPSE. Finally, on June 13, the patient was labeled as recovered COVID-19 patient. CSPPSE is a complication of COVID-19 pneumonia, even in previously normal lungs.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"8 1","pages":"129 - 132"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79608070","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":"Anosmia as a screening tool to detect asymptomatic patients with coronavirus disease 2019","authors":"Anis Abobaker","doi":"10.4103/LJMS.LJMS_50_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_50_20","url":null,"abstract":"","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"36 2","pages":"150 - 151"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91512331","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}
A. Nair, Sreethish Sasi, Samar Hashim, M. Al-Maslamani
{"title":"Disseminated geotrichosis in a patient with prolonged neutropenia: A rare case report and literature review","authors":"A. Nair, Sreethish Sasi, Samar Hashim, M. Al-Maslamani","doi":"10.4103/LJMS.LJMS_14_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_14_20","url":null,"abstract":"Disseminated fungemia due to non-Candida yeasts is emerging as an opportunistic infection in hematological malignancies with prolonged neutropenia. Invasive infections by Geotrichum spp. are extremely rare and constitute only about 1% of all non-Candida yeasts. The mortality in such patients is high and is seldom reported in the literature. Here, we describe the case of a middle-aged male with treatment-resistant Hodgkin's lymphoma who developed invasive Geotrichum capitatum infection during his neutropenic phase, with poor response to combination therapy with voriconazole and amphotericin B. He was diagnosed from blood culture but succumbed to death on day 10 of admission in spite of treatment with multiple lines of antifungals. G. capitatum is responsible for fatal fungemia in patients with prolonged neutropenia complicating hematological malignancies. A high index of suspicion is required in this patient group to identify disseminated geotrichosis as delay in treatment worsens mortality.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"23 1","pages":"140 - 142"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81335621","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":"Coronavirus disease 2019 pandemic: An overview of the event","authors":"Bashir Bashir Mohammed","doi":"10.4103/LJMS.LJMS_31_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_31_20","url":null,"abstract":"","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"63 1","pages":"49 - 51"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73599715","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":"Management of diabetes in patients with coronavirus disease 2019: A practical approach","authors":"M. Eledrisi, Abdel-Naser Elzouki","doi":"10.4103/LJMS.LJMS_34_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_34_20","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has emerged as a rapidly transmissible communicable disease around the globe. Diabetes is reported as a common morbidity in patients with COVID-19, has been associated with worse clinical outcomes, and may lead to higher mortality. Because the disease has variable presentations varying from mild respiratory symptoms to pneumonia and respiratory failure, proper care of patients with diabetes in this context should cover both outpatient and inpatient sectors. Outpatient management in acutely ill patients includes frequent home glucose monitoring; holding certain medications including metformin, sodium glucose co-transporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists that may cause unwanted side effects such as dehydration and resulting acute kidney injury; continuation and adjustment of insulin therapy; and patient education on indications to seek medical assistance. Inpatient glucose management of patients admitted with COVID-19 involves holding noninsulin medications, monitoring blood glucose, and starting insulin if glucose levels are not in target. Intravenous insulin is recommended for critically ill patients with uncontrolled glucose. Universal measures should include assurance of continuity of care, adherence to therapy, and self-management education using connected health models and telemedicine. Patients with diabetes are considered a vulnerable group during periods of epidemics, and clear recommendations and pathways are essential to assure patients' safety.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"65 1","pages":"58 - 64"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84428646","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}
E. Gusbi, Nada Elgriw, Shiaa Zalmat, H. Alemam, Sumia Khalil, Mokhtar Gusbi, Miluda Elhamadi, Taha Benyasaad, N. Enattah, A. Elzagheid
{"title":"Breast cancer in western part of Libya: Pattern and management (2003-2018)","authors":"E. Gusbi, Nada Elgriw, Shiaa Zalmat, H. Alemam, Sumia Khalil, Mokhtar Gusbi, Miluda Elhamadi, Taha Benyasaad, N. Enattah, A. Elzagheid","doi":"10.4103/LJMS.LJMS_5_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_5_20","url":null,"abstract":"Background: Breast cancer is the second most common cancer in the world; the most frequent cancer among women, and leading cause of cancer death in females worldwide. Aim: The aim of the study is to study the pattern and treatment modalities for breast cancer patients who registered in Tripoli University Hospital from 2003 to 2018. Patients and Methods: A retrospective, cross-sectional study was conducted at the Oncology Department of Tripoli University Hospital. A convenience sample of 1000 breast cancer patients from 2003 to 2018 was chosen. Demographic, clinic-pathological characteristics, and treatment modalities data were analyzed by SPSS program version 20. Results: Of 1000 breast cancer patients, there were 984 (98.4%) females and 16 (1.6%) males, mean age was 46.1 ± 11.7 years old, most of them from western region. Majority (64.3%) of female were early age at menarche and 46.2% not breastfed. Positive family history of first degree was 28.8%. The left side presentation was the predominant (60.3%); half of the cases were in Stage II. Invasive ductal carcinoma was diagnosed among 62.5% of the cases and 47% of them were in Grade III. Positive estrogen receptor recorded in 73.8% of cases compared to 69.5% positive progesterone. Furthermore, 76.8% of patients had human epidermal growth factor receptor 2 negative and 78.4% of cases had high Ki-67 level. Regarding management, a combination of surgery, radiation, chemotherapy, and hormonal were provided to 58% of cases, 45.5% of patients who received chemotherapy were treated with FEC regimen. Hormonal therapy was given to 67.7% and tamoxifen is the most drugs used. Conclusions: The frequency is higher among younger age (<50 years), early age at menarche, breastfed less than a year, nearly half presented in late Stage (III, IV), invasive ductal carcinoma is predominant histopathological type, most cases were HER2 negative and high Ki-67 expression. More efforts toward primary prevention and early detection are recommended to reduce locally advanced breast cancer.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"12 1","pages":"65 - 71"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87579840","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":"Coronavirus disease 2019: The story so far","authors":"A. Omrani","doi":"10.4103/LJMS.LJMS_33_20","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_33_20","url":null,"abstract":"Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged in China in late 2019 and became a global pandemic by March 2020. SARS-CoV-2 is a highly transmissible virus that causes a clinical illness known as Coronavirus Disease 2019. The clinical spectrum ranges from mild respiratory and generalized symptoms to severe pneumonia with multiple organ failure. Overall mortality is high in older patients and those with comorbidities such as obesity and cardiovascular disease. Diagnosis is usually confirmed by polymerase chain reaction on upper or lower airway samples. Clinical management is largely supportive; no specific therapeutic options are currently available. Public health interventions have thus far been centered around social distancing, large-scale testing, and isolation. An unprecedent global effort has been mounted for the rapid development of effective SARS-CoV-2 vaccines. Until such time, further waves of SARS-CoV-2 are likely, if the restrictive control measures are removed.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"34 1","pages":"52 - 57"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82509959","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":"Association between pterygium and dry eye among patients in Benghazi, Libya","authors":"O. Omran, S. Bukhatwa","doi":"10.4103/LJMS.LJMS_62_19","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_62_19","url":null,"abstract":"Background and Aim: Pterygium is a relatively common condition of the conjunctiva that affects people at different stages of life. Dry eye disease (DED) is a well-known associated morbidity with pterygium. The aim of this study was to investigate the association between pterygium and dry eye among otherwise healthy Libyan people. Methods: A case–control study was conducted on patients attending Al-Keish Polyclinic in Benghazi. Two techniques have been applied individually, in parallel and in series for all of the study participants, Schirmer's test and break-up time (BUT) test. Results: This study included 50 eyes belonged to 35 patients with a median age of 37 (range 26–65) years, and among those, 18 (51.4%) cases (25 eyes) had pterygium and a group of 17 (48.6%) cases (25 eyes) were control. Rates of DED diagnosis were highest using parallel testing (positive results in any of the tests) than with BUT and Schirmer's test individually and lowest using series testing (positive results in both tests). Eyes with pterygium showed obviously and statistically significant higher rates of positive test results. All controls were normal testing with Schirmer's test and hence in series testing. Conclusion: Testing for DED using parallel combined testing (BUT and Schirmer's test) relying on positive result of any of the tests increases sensitivity and may increase the value of the test for screening for dry DED among particular high-risk groups.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"2 1","pages":"80 - 83"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76626262","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":"Chondroma of the nose","authors":"S. Swain, J. Mohanty","doi":"10.4103/LJMS.LJMS_36_19","DOIUrl":"https://doi.org/10.4103/LJMS.LJMS_36_19","url":null,"abstract":"Chondromas of the head-and-neck area are rare lesions and more rare over the nose. Chondroma is a benign neoplasm of cartilaginous origin. It is rarely seen over the dorsum of the nose. It causes cosmetic deformity of the nose and face if it arises from the nose. The diagnosis is confirmed by histopathological examination. The treatment is complete surgical excision. We report a case of chondroma arising at the dorsum of the nose which is slightly mobile. Computed tomography scan showed a mild enhancing lesion at the dorsum of the nose which was completely excised via transcolumellar route. Considering its rarity at the dorsum over the nose, we reported this solitary chondroma of the nose. Chondromas have to be kept in mind during evaluation of any mass over the nasal dorsum.","PeriodicalId":18055,"journal":{"name":"Libyan Journal of Medical Sciences","volume":"102 1","pages":"87 - 89"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78957180","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}