Abstract... Inflammation is the self-protective reaction of tissues towards infection, irritants, or foreign substances. Though it is a part of host defense mechanism, when it becomes severe, it turns out to be a hopeless condition which causes damage of tissues; hence control of inflammation becomes essential. This paper presents a study of antiinflammatory effect of ibuprofen-witepsol H15 rectal suppositories versus oral route of administration using intraperitoneal (IP) route as positive control. Suppositories were prepared using fusion method and tested for physico- chemical properties according to British Pharmacopeia (B.P) 2007 procedures. Screening for anti-inflammatory ac- tivity of ibuprofen was carried out against carrageenan-induced rat paw oedema in wistar strain albino rats (200 ± 20
g) of either sex. The formulated suppositories were found to satisfy B.P, requirements for weight variation, liquifica- tion time, disintegration time, hardness values and content uniformity. The entrapment efficiency (%) of ibuprofen
was 99-100 % w/w for all the tested suppositories. The increase in paw oedema volume significantly (p< 0.0001) inhibited using ibuprofen-witepsol H15 rectal suppositories compared to control. The total area under the curve (AUC) for paw volumes time curve were reduced from 5.54 ml/h for control to 3.45, 4.38 and 4.78 ml/h using rectal suppositories, oral and IP routes. The anti-inflammatory inhibition (%) achieved after 4-5 hours was 40.58, 29.87
and 65.87, after rectal suppositories, oral and I.P routes of administration respectively. The total AUC (%) of inhibi- tion were 33.81, 27.07 and 62.16 at 4 and 5 hours. using, rectal suppositories, oral and IP routes of administration respectively. The results justified the use of suppositories in the treatment of inflammation when oral route is unreliable.
Abstract... The purpose of our study was to evaluate the role of Multi Detector Row Computed Tomography Angiography (MDCTA)
in evaluating the Peripheral Arterial Disease (PAD) affecting the lower limb for Libyan patients presented with clinical manifestations. Thirty-eight patients referred in the period from December 2017 to March 2018 for Computed Tomogra- phy Angiography (CTA) of lower limb vessels to evaluate and diagnose the diseases of peripheral lower extremities arteries. For evaluation of the lower extremities arterial diseases 128-Row MDCT (Toshiba Aquilion, Japan) was used. After preparation of the patients, we used intravenous line for non-ionic iodinated contrast injection and the patients were
scanned from renal level to the toes who took 20-30 seconds for scanning. Three-dimensional (3-D) visualization was essential. Thirty-eight patients with clinical manifestations referred for CTA of lower limbs arteries were with atheroscle- rotic steno-occlusive disease. 28 patients had claudication, 34 patients had rest pain with ischemia, 38 patients had Diabe- tes Mellitus (DM) and only two patients were with trauma. The scanning of the lower extremities’ arteries showed singu- lar or multiple atherosclerotic stenosis or occlusion. The largest group among the referred patients with clinical manifesta- tions was diabetic mellitus group and the smallest one was trauma group. MDCTA is preferred tool for evaluation of lower extremities arteries of patients with clinical manifestation. The arterial steno-occlusion increased by increasing age and
more among males than females. Highly detected lower extremities’ arteries of atherosclerotic steno-occlusive disease
were in patients with clinical manifestations (claudication, rest pain with ischemia, diabetes mellitus and trauma).
Abstract... The spread of resistant Enterobacteriaceae to antibiotics in chicken farms constitute a reservoir of resistant genes that could be easily transmitted to contact human. So, this study conducted to investigate the prevalence of ciprofloxacin and gentamycin resistance profiles and the frequency of aac (6')-Ib gene in chicken farms in Misurata city and living population in the vicinity of these farms. (135) cloacae swab from chicken and (107) urine samples from human living in these farms were collected. Isolation and identification of different Enterobacteriaceae strains is performed in antibiotic resistance profiles against ciprofloxacin and gentamycin antibiotics. DNA extracted from each sample and further screening for aac (6')-Ib-cr in ciprofloxacin and/or gentamycin resistant isolates by using of using PCR technique. Our results showed that 88.8% and 93.4% of chicken and human isolates confirmed to be En- terobacteriaceae respectively. There were non-significant association between the source of Enterobacteriaceae iso- lates and quinolones or aminoglycosides resistance profiles. The screening of the genetic determinant of gentamycin and ciprofloxacin resistance aac (6')-Ib-cr, revealed an impressive proximity between the frequency of this gene within the chicken and human isolates (33.6%, 33 %) respectively. In conclusion quinolones and aminoglycosides resistance profiles and the frequency of aac (6')-Ib-cr between chicken and human were nearly comparable, that would suggest the possible transmission of this gene from chicken to human.
Abstract... Acinetobacter baumannii is an opportunistic pathogen causing various nosocomial infections. The aim of this study was to characterize the molecular support of carbapenem-resistant A. baumannii clinical isolates recovered from four hospitals in Tripoli, Libya. Bacterial isolates were identified and antibiotic susceptibility testing was performed using automated sys- tem. Carbapenem resistance determinants were studied phenotypically using two different techniques: E-test; chromogenic culture media. Polymerase chain reaction (PCR) amplification was used to determine the presence of bla OXA23 and blaOXA51 genes among isolates. A total of 119 isolates were characterized, overall the resistance prevalence was extremely high
for aminoglycosides (79-96.6%), fluoroquinolones (94-96%), cephalosporins (96.6-100%) and carbapenemes (93.2-
100%), all isolates were susceptible to colistin. In addition, 97.5% of isolates were identified as multidrug resistance (MDR). Varying degree of phenotypic detection of carbapenemes was determined; highest levels of carbapenemes were detected using chromogenic media (76.5%) compared with E-test (45.4 %). The carbapenem resistance-encoding genes detected were blaOXA23 (84%) and blaOXA51 (73.1%); the highest occurrence of blaOXA23 was demonstrated in Tripoli’s Cen- tral Hospital (5/5; 100%) then in Tripoli Medical Center (44/51; 86.27%). The co-occurrence of these genes was demon- strated in (75/119; 63%) showing dissemination of carbapenemes resistance MDR A. baumannii in hospitals. This study shows that the high prevalence of OXA-23 contribute to antibiotic resistance in Libyan hospitals and represents the high incidence of the association of these two carbapenemases in an autochthonous MDR A. baumannii isolated from patients
in Libya, indicating that there is a longstanding infection control problem in these hospitals.
Abstract... It is imperative for pregnant women to know their hepatitis status to prevent transmission to their newborn during deliv- ery. Serological screening for viral hepatitis should be offered to pregnant women, as babies born to a mother with hepati- tis B have 90% chance of developing chronic hepatitis B if they are not properly treated at birth. So postnatal intervention can be offered to women infected with Hepatitis B to decrease such risk of transmission. To evaluate the incidence of viral hepatitis among women in their third trimester admitted to labour ward, and to determine the magnitude the problem in our locality. A retrospective study was conducted targeting all women delivered in the Department of Obstetrics & Gynae- cology at Misurata Central Hospital; patient’s data was obtained from medical records of these women during the year
2016. All of them were screened for viral infections (Hepatitis B & C as well as HIV) during their antenatal care in the third trimester. During delivery proper preventive techniques are implemented, including effective ‘decontaminate the
hands’, and use rigorous infection control procedures. For needle stick injuries or splash of body fluid with hepatitis B are recorded and immune prophylaxis is given. Appropriate hygienic precautions should be taken for newborn. In addition to routine vaccination; newborn to HBsAg-positive mothers should receive passive immunization with HBIG at birth. A total
of 7142 deliveries including 156 multiple births were recorded. Of them 52 had viral hepatitis B giving an incidence of 0.7%. Hepatitis B represented 91.2% of the cases while hepatitis C accounted for 9.8% of the cases. They were aged be- tween 18 and 42 years. 90% of them were Libyan and 48% were resident outside Misurata. 79% were multiparous. Of the total cases 32.7% were delivered by Cesarean section. The current study revealed a low incidence of Hepatitis B and C in our localit
Abstract... There is increasing evidence that the self-medications among pregnant women is common in many developing countries. Despite the adverse impact on pregnancy, there are few programs available for their control. The objec- tive of this study was to assess the level of self-medication by antibiotics amongst Libyan pregnant women in order to determine the drug misuse, development of resistance and the possible harmful effects on fetus. Four hundred pregnant women, aged between 18 and 40 years were drawn from outpatient obstetric clinics and hospitals in Misurata city and assessed for self-medication by antibiotics, adapted from a self-report questionnaire based on the WHO guidelines for antibiotic misuse survey. Of the 400 pregnant women assessed, 61 (15.3%) indulged in the selfuse of antibiotics for common cold, fever cough and pelvic pains (not prescribed from the antenatal clinic), 107
(26.8%) didn`t complete the full course of the drug (prescribed from the antenatal clinic) when they felt any im- provement. A total of 211(52.7 %) pregnant women complete the full course of the drug and 21 (5.2%) are not
aware in antibiotic misuse in pregnancy. There was a significant difference in the pregnant women whom completed the full course of the drug and those don`t complete it. (X2=10.97, p=0.001); There was also a significant difference between the presence of current pregnancy illness and antibiotic misuse (X2=9.04, p=0.001) There was no signifi- cant difference among pregnant women who were highly educated compared to those with little or no education.
However, the level of education has no strong impact in the self-usage of antibiotics as shown above. No fetal com- plications related to misuse was detected. This study shows that self-medication is not uncommon among pregnant women in our environment. There is need for adequate education of pregnant women during antenatal clinics on the potential danger of antibiotic self-medication so as to prevent child and maternal morbidity and mortality
Abstract... The aim of this study is to determine the orthodontic treatment need of Libyan schoolchildren using the Index of Orthodontic Treatment Need (IOTN) and the amount of contribution of the various occlusal traits in rating of the children in IOTN scale. This data provides solid information for planning of orthodontic care and give hard base about the most occlusal traits in producing malocclusion in Libyan schoolchildren. In this cross-sectional study of School-going children aged 14-15 years, their parents consented to an intra-oral examination. A total of seventeen schools in Misurata were selected and a total of 1,050 children were entered into the study. Five children (0.5%) had previously received orthodontic treatment and these children were excluded from the study. The gender of the sam- ple population was remarkably even and comprised 522 males (49.7%) and 528 females (50.3%). The mean age of male students was 15.3 years old, while that of female students 15.5 years old. However, the age range was slightly larger with the youngest students 13 and 17 years old. The study found that 27 percent of children were in Dental Health Component grade 5 and 4 and therefore in definite need for orthodontic treatment. Less than 24 percent of children (grade 3) were in borderline need and 49% (grade 2and 1) had little or no need for treatment. The contribu- tion of the main occlusal features responsible for definite need respectively as follow; severe contact displacement (4d) 34.3 per cent, overjet greater than 6 mm but less than or equal 9 mm (4a) 17.3 per cent, crossbite with dis- placement greater than 2 mm (4c) 14.1 per cent, impeded eruption (5i) 14.1 per cent, less extensive hypodontia (4h) 7.1 per cent, overjet greater than 9 mm (5a) 6 per cent, partially erupted, tipped and impacted against adjacent teeth (4t) 4.6 per cent, submerged deciduous teeth (5s) 1.1 per cent, reverse overjet greater than 3.5 mm with reported masticatory and speech difficulties (5m) 0.7 per cent and 0.4 percent for both extreme lateral or anterior open bite greater than 4 mm (4e) and presence of supernumerary teeth (4x).
Abstract... Infection control is an essential part of dentistry. Potential pathogens can be transported to laboratory via orally soiled impressions and dental prostheses. The purpose of this study was to investigate the attitude and behavior of dental laboratories within Misurata city to cross infection control. A survey was conducted to collect data on the crossinfection procedures adopted by 40 dental laboratories within Misurata city from November 2010 to February 2011. The resultant responses to each question of the five-part questionnaire were then analyzed using (SPSS 15.0 for windows). The results of the study demonstrated that the attitudes and procedures of dental laboratories within Misurata city to infection control appeared to be very variable 20% of dental laboratories have documented procedure for infection control. Only 3% of dental laboratories used liquid disinfectants, 15% change their pumice daily and 35% have exhaust systems containing filter. In addition, most of the laboratories (77.5%) devoid running water or separate hand washing facilities. Furthermore, 10% of dental technicians attended infection control training courses and 32.5% believed in immunization against hepatitis B. Moreover, most of dental technicians (55%) were not care about the use of protective measures, during either handling new items or polishing of prostheses. There seems to be a definitive need to provide and distribute formal and obligatory standard of current infection control guidelines and manuals to the dental laboratories.
Abstract... Surgical site infections (SSIs) are the most common postoperative complications and represent a significant burden in terms of patient morbidity, mortality, and health costs. Choice of regimen, time of administration, and duration of antibi- otic prophylaxis were inappropriate in 25-50% of cases from previous studies. Therefore, the main aim is to evaluate the appropriateness of antimicrobial prophylaxis use in surgery at the Misurata Central Hospital (MCH). The study included 247 surgical inpatients of any age, who were admitted and discharged from surgical departments: gyneocology and obstet- rics, orthopedics, and general surgery in the Misurata Central Hospital (MCH) over a period of six months from (1st Janu- ary to 30th June 2016). The total of 247 patients underwent surgery and administered antimicrobial prophylaxis in the peri- operative period. Appropriateness of antimicrobial prophylaxis was evaluated according to published guidelines of the American Society of Health-System Pharmacists (ASHP) for every aspect of antibiotic prophylaxis. All data were coded and analyzed using statistical software (Stat View version 5.1). The study showed 94.3% of prescribed and administered prophylactic antibiotics were in accordance with the American Society of Health-System Pharmacists (ASHP) guidelines regarding prophylaxis indication. The total compliance for the studied parameters was (3.2%), only (10.5%) had appropri- ate antibiotic selection, and (50.6%) of patients received antibiotic in appropriate duration. The general surgery department had higher total adherence to the ASHP guidelines (P=0.006). The gyneocology department had much compliance regard- ing duration of antibiotic use (P = 0.00001); however, general surgery had higher proper antibiotic selection (P = 0.0001). A lack of concordance between the use of antimicrobial prophylaxis and prescribing guidelines was identified in this study at the MCH.
Abstract... A new cyclohexapyrazoline compound was synthesized by reacting 2,6-bis(4-(dimethylamino)benzylidene) cyclohexanone (I) with hydrazine hydrate in methanol utilizing the microwave technique. The structure of the new cyclohexapyrazoline compound was confirmed by elemental and spectral analysis. Finally, the antimicrobial activity of the new cyclohexapyrazoline compound (II) was studied.
Abstract... Nosocomial infections persist as a major problem in neonatal intensive care units. Neonates in the NICU are vulnerable to many nosocomial infections from multiple devices for treating or monitoring their care. Thus, healthcare workers should have sound knowledge and strict adherence to infection control standard precautions. To assess the knowledge and prac- tice of standard precautions among neonatal intensive care unit (NICU) healthcare workers in Misurata teaching hospital.
A descriptive cross-sectional study was carried out on a sample of 28 consenting doctors, nurses and laboratory scientists in Neonatal Intensive Care Units of Misurata Teaching Hospital, Libya, during the period from March to May 2015. Data was collected through two tools: a) Structured questionnaire to assess knowledge level about standard precautions; and b) Performance observational checklist to assess practice of standard precautions. Data was analyzed using SPSS version 18. Majority of the studied HCWs are females (71.4%), belonged to the age group of 20-30 years (57.1%), with work experi- ence less than 10 years (64.3%) and only 21.4% received infection control training. The overall mean knowledge score toward standard precautions is 68.4%, but mean practice score is 47.4%. And all scores are significantly lower among those who were non-trained. 89.3% of staff had good awareness in hand hygiene moments, 53.6% aware of hand washing steps, but only 32.1% actually practiced it right. While 85.7% of the staff had knowledge in use of personal protective
equipments and fresh gloves, only 67.8% wore in practice. 53.6% knows about oral health care practices protocol, only 35.7% actually did it. 75% of the staff are aware of sterile technique in CVC care, 57.1% followed catheter care practices as per protocol. 64.3% are aware how to dispose wastes and sharps off in a right way, 46.3% did it frequently. While
85.7% are satisfied about instruments sterilization, only 39.3% of HCW reported that NICU environment is clean. There is inadequate knowledge and poor compliance with standard precautions of infection control among NICU health-care staff in Libya. It is very important to develop infection control policy and protocols that strengthen the training of HCW in standard precautions to improve not only their knowledge but also their practice.
Abstract... Evaluate drug resistance of bacteria isolated from equipment placed close to patients in an Intensive Care Unit of a Central hospital in Gharian.Libya is a lower middle-income country with no national surveillance system for hospitalacquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) in Libya.This is a cross-sectional study. The samples were collected with swabs moistened with Trypticase Soy Broth, which were then cultured in sheep blood agar and MacConkey agar. The phenotypic identification performed was based on the morphology of the strains and biochemical results. The drugs resistance analysis was based on Kirby-Bauer’s Disk Diffusion protocol. Results:A rate of 94.4% of the analyzed equipment was contaminated. The most frequently isolated microorganisms were: Acinetobacter sp., Staphylococcus aureus and
Pseudomonas sp. Just about 75% of Acinetobacter sp. was resistant to piperacillin associated to tazobactam, mero- penem and levofloxacin. Similarly, 36.3% of S. aureus showed resistance to oxacillin and 10% of Pseudomonas sp. was resistant to the drugs tested.
Abstract... Hospital waste management is a crucial environmental and public safety issue. Discharge water is one of the main sources of groundwater and rivers contamination if not treated efficiently Hospitals consume an important volume of water a day, and generate multiple amounts of infectious and hazardous polluted discharge water to the drain. These pollutants should be treated by the wastewater treatment plant (WWTP) of each hospital before release to the municipal drainage. This study aims at presenting the primary results on characterization of hospital wastewaters in some hospitals in Northeastern part of Libya. Four major hospitals were selected for this study ranging from 500 to
120 beds per hospital, none of them have a wastewater treatment plant, and the wastewater is rejected untreated to the public sewage. This addition of polluted wastewater will increase the load to the WWTPs of the city and reduce the efficiency of treatment processes leading to hazardous pollution in the future. Analysis of the concentration of biochemical oxygen demand, chemical oxygen demand, total suspended solids, sulfate, nitrate, nitrite, ammonia, chlorides, and oils and grease. Heavy metals were also investigated as Cr, Cd, Pb, Hg, Cu, Ni and Zn. The bacterio- logical parameters were carried out using the standard microbiological techniques. The study was conducted during the period of (15/4/2014 - 15/6/2014). The study showed an increase in the concentration of pollutants which is higher than the Libyan and WHO guidelines of raw wastewaters.
Abstract... Hospital waste management is a crucial environmental and public safety issue. Discharge water is one of the main sources of groundwater and rivers contamination if not treated efficiently Hospitals consume an important volume of water a day, and generate multiple amounts of infectious and hazardous polluted discharge water to the drain. These pollutants should be treated by the wastewater treatment plant (WWTP) of each hospital before release to the municipal drainage. This study aims at presenting the primary results on characterization of hospital wastewaters in some hospitals in Northeastern part of Libya. Four major hospitals were selected for this study ranging from 500 to
120 beds per hospital, none of them have a wastewater treatment plant, and the wastewater is rejected untreated to the public sewage. This addition of polluted wastewater will increase the load to the WWTPs of the city and reduce the efficiency of treatment processes leading to hazardous pollution in the future. Analysis of the concentration of biochemical oxygen demand, chemical oxygen demand, total suspended solids, sulfate, nitrate, nitrite, ammonia, chlorides, and oils and grease. Heavy metals were also investigated as Cr, Cd, Pb, Hg, Cu, Ni and Zn. The bacterio- logical parameters were carried out using the standard microbiological techniques. The study was conducted during the period of (15/4/2014 - 15/6/2014). The study showed an increase in the concentration of pollutants which is higher than the Libyan and WHO guidelines of raw wastewaters.
Abstract... Yoghurt is one of the most well-known food products that contain a variety of microbes that has the ability to render the customers into danger. The aim of this study is to evaluate the microbial content of fermented milk products in Misurats's markets, 20 samples have been collected for plain, fruit, and fla- vored yoghurt. These samples were transported to the lab to perform microbial examinations. First of all, the pH was measured in the yoghurt samples which were 4.58±0.27 in plain yoghurt, 4.6±0.23 in fruit yoghurt and 4.61±0.22 in flavored yoghurt. In addition to bacteria, some yeasts and fungal species iso- lated including Saccharomyces cerviceae, Candida parapsilosis, Pichia, Rhodotorula rubra, Penicillium, Aspergillus, and Rhizopus were isolated from the examined plain yoghurt samples in the percentage of 50%, 37.5% and 12.5% respectively. While in fruit yoghurt only Mucor and Penicillium were isolated
giving 33.3, 66.6% respectively, while in flavored yoghurt only Penicillium was isolated by the percent- age 100%. When our results were compared with the Libyan standard 4 out of 20 samples were not acceptable in all types of examined yoghur.
Abstract... Inhalation injury has now become the most frequent cause of death in burn patients. Although mortality from smoke inhalation alone is low (0–11%), smoke inhalation in combination with cutaneous burns is fatal in 30 to 90 percent of patients. It has been recently reported that the presence of inhalation injury increases burns mortality rate. Identify incidence and epidemiological features of inhalation injury among fire burned patients and analysis of the outcome of our management. Retrospective study of all patients admitted to ICU burn in Burn and Plastic Surgery Hospital, Tripoli-Libya with inhalation injury from January 2015 to December 2016. Total number of admitted patients to ICU was 293, out of them 161 (55%) sustained inhalation injury,126 (78%) patients out of 161 patients were male gender, 138 (86%) patients out of 161 were more than 15 y old in age, 70% of non-survived patients group were with inhalation injury. High incidence of inhalation injury among patients with fire burn who admitted to ICU, Inhalation injury increase mortality by 20%, Inhalation injury had occurred more frequently in adult male gender, Bad prognosis in inhalational injured patients complicated by infection and septicemia, Early diagnosis and intubations decline mortal- ity and morbidity rat.
Abstract... Inhalation injury has now become the most frequent cause of death in burn patients. Although mortality from smoke inhalation alone is low (0–11%), smoke inhalation in combination with cutaneous burns is fatal in 30 to 90 percent of patients. It has been recently reported that the presence of inhalation injury increases burns mortality rate. Identify incidence and epidemiological features of inhalation injury among fire burned patients and analysis of the outcome of our management. Retrospective study of all patients admitted to ICU burn in Burn and Plastic Surgery Hospital, Tripoli-Libya with inhalation injury from January 2015 to December 2016. Total number of admitted patients to ICU was 293, out of them 161 (55%) sustained inhalation injury,126 (78%) patients out of 161 patients were male gender, 138 (86%) patients out of 161 were more than 15 y old in age, 70% of non-survived patients group were with inhalation injury. High incidence of inhalation injury among patients with fire burn who admitted to ICU, Inhalation injury increase mortality by 20%, Inhalation injury had occurred more frequently in adult male gender, Bad prognosis in inhalational injured patients complicated by infection and septicemia, Early diagnosis and intubations decline mortal- ity and morbidity rat.
Abstract... An exposure that might place CHW at risk for HCV infection is defined as a percutaneous injury (e.g. a needle stick or cut with a sharp or contact with mucus membrane or non-intact skin or other body fluids that are potentially in- fectious) Feces, nasal secretions, saliva, sputum, sweat, tears, urine, vomitus, are not considered potentially infec- tious unless they contain blood. Avoiding occupational blood exposures is the primary way to prevent transmission of HCV in health care settings. HCV is not transmitted efficiently through occupational exposures to blood. The average incidence of anti HCV seroconversion after accidental percutaneous exposure from an HCV positive source is 1.8% (Range 0% -7%) Transmission occurred only from hollow –bore needle, compared with other sharps. Data are limited on survival of HCV in the environment. In contrast to the HBV the epidemiologic data for HCV suggest that environmental contamination with blood containing HCV is not a significant risk for transmission in the health care settings with the possible exception of the hemodialysis setting where HCV transmission related to environ- mental contamination and poor injection control practices have been implicated. The risk for transmission from ex- posure to fluids or tissues other than HCV infected blood also has not been quantified but is expected to be low. Data upon which to base a recommendation for therapy of acute infection are insufficient because no data exist re- garding the effect of treating patients with acute infection who have no evidence of infection.