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   2016| July-August  | Volume 8 | Issue 4  
    Online since July 11, 2017

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Trichomonas vaginalis infection in women with type 2 diabetes mellitus and vaginal discharge in Benghazi, Libya
Eman Z Younis, Adela H Elamami
July-August 2016, 8(4):109-113
Background: There is a wide variation in the prevalence of Trichomonas vaginalis in Libyan women. There are no data on prevalence in Libya women with diabetes, a known risk factor for increased genital infection. Objective: We wished to ascertain the prevalence of Trichomonas vaginalis infection in diabetic women with vaginal discharge in Benghazi, Libya. Patients and Methods: A cross-sectional study was performed at one specialized polyclinic between November 2011 and December 2013. One hundred and ten pregnant and non-pregnant diabetic women aged 17-52 years who complain of vaginal discharge were interviewed and high vaginal swabs were taken and tested with wet mount and culture to detect Trichomonas vaginalis, candida and bacteria. Random blood glucose levels and VDRL tests were also done for all patients. Results: 27 out of 110 vaginal swabs (24.5%) were positive for Trichomonas vaginalis. The age of the patient, color and smell of the vaginal discharge significantly concurred with the Trichomonas vaginalis infection status. Highest rate of infection (50%) was observed in diabetic women over 40 years of age. Non-pregnant diabetic women had a slightly higher prevalence (27.7%) than pregnant diabetic women (22.2%). Eighteen of all vaginal discharge (16.4%) were positive for Candida albicans. Bacterial vaginosis was mostly due to Staphylococcus spp (100%). Additionally, 4 patients (3.6%) had a positive VDRL test. Conclusion: Nearly quarter of women with type 2 diabetes mellitus presenting with vaginal discharge in Benghazi had Trichomonas vaginalis infection. This is markedly higher than previously reported rates in the general female population of the city.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  2,314 139 1
Impact of Socializing, Fasting and Feasting on Day to Day Blood Glucose Profiles in Diabetes Elucidated by the FreeStyle® Libre System
Salem A Beshyah, Marcil Haddad
July-August 2016, 8(4):114-119
Background: Total day-time fasting is observed by millions of adult Muslims during the whole lunar month of Ramadan. However, many people, particularly elderly men and women, do fast isolated or somehow consistent days outside Ramadan. This may pose clinical management challenges. Case Report: A case of an elderly diabetic man observing day-time Ramadan-type fasting on Mondays and Thursdays throughout the year is described. Detailed blood glucose (BG) profiles over a 10 week period were captured using the FreeStyle® Libre Flash glucose monitoring system. Detailed study of these profiles revealed three distinctly different BG patterns every week. One pattern on the two fasting days (Mondays and Thursdays) with blood glucose peaking after dawn and after sunset with a downward trend throughout the day. A second pattern on Fridays with the BG levels that peak and remain high for a few hours in the early afternoon following the large and rich weekly family meal. The third pattern was seen on the remaining 4 non-fasting days where BG starts to rise in the midmorning reflecting the patient's life style of hosting and sharing with his business clients. Such detailed and visually presented information gave insights into his BG daily patterns enabling his therapeutic plans for hyperglycemia to be tailored on daily basis. Conclusions: This is the first documentation of glucose profiles during “Ramadan-type fasting” and feasting using the flash glucose monitoring system. In addition to detailed clinical and social history, use of medical technology may occasionally help resolve some difficult blood glucose patterns.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  1,243 124 1
Metformin treatment decreases mTOR mRNA level in MCF-7 breast cancer cells
Mohamed Alalem, Alpana Ray, Bimal K Ray
July-August 2016, 8(4):99-108
Besides the involvement of mTOR activity in several cancer conditions, evidence exists that increased total mTOR protein level might be linked to some cancer conditions such as colorectal carcinoma. The increase in total mTOR protein level in colon cancer was found to be associated with enhanced tumor progression and poor prognosis. Total mTOR protein level is elevated in breast cancer cells compared to their nonmalignant counterparts. High mTOR protein level in breast cancer cells could be attributed to decreased mTOR protein degradation, increased mTOR protein expression, or both. Increased protein expression may involve an increase in the gene expression. Here, we investigated the possibility of increased MTOR gene expression as a potential underlying cause of the elevated total mTOR protein in breast cancer cells. Our results suggest that transcription of MTOR gene is increased in the estrogen receptor positive (ER+) MCF-7 breast cancer cells compared to other breast cell lines. DNA sequencing of the MTOR promoter identified sequence variations in MCF-7 cells, which could be potentially involved in upregulation of mTOR expression. Among these variations is a truncation of guanine thymine dinucleotide (GT) n repeat region in MCF-7 cells, which might be possibly implicated in the elevated transcription of MTOR gene in these cells. Moreover, our results revealed that metformin treatment, profoundly decreased mTOR mRNA levels in MCF-7 breast cancer cells. In conclusion, unraveling the potential mechanisms involved in the regulation of mTOR expression in breast cancer cells could provide an avenue for optimizing the efficacy of breast cancer treatment regimens.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  1,222 144 1
Applicability of the world health organization's healthcare system framework: A consensus development study in Libya
Elhadi H Aburawi, Murad H Ghrew, Taufik Zoubeidi, Hani T.S Benamer, Abdulbaset A Elfituri, Hisham H Ziglam, Ali A Aboutwerat, Nabil A Alagili, Samir A Sagar, Hanan E Aburawi, Reida M El Oakley
July-August 2016, 8(4):89-98
Introduction: The World Health Organization (WHO) Health Systems Framework (HSF) with its 6 building blocks is a widely accepted tool for accurate evaluation of health systems. However, its role in the developing world has not been widely assessed yet. Methods: Six Questionnaires with 5-point Likert-scale were designed and distributed to all the attendees of Libya Health 500 (LH500) Conference, and collected just before the group discussion of Libyan health system's session. Results: There were high levels of agreement of the respondents to the questionnaires items about the 6 building blocks. The application of evidencebased medicine and equal provision of health service to all, received the highest levels of agreement. Most of the attendees agreed that health services should be paid by the health insurance system, as it has many advantages, including the peace of mind for the public. The fairness and efficiency of the workforce and the establishment of regulatory mechanisms to address the needs of the health workforce had a high level of agreement. Moreover, a functioning health technology requires an effective supply and distribution system of technology elements. The participants agreed that health information technology is important to improve healthcare services and to prevent financial and administrative corruptions. Conclusion: It is feasible to adapt the WHO-HSF to identify the needs and ways to enhance health systems in the developing world. The Libyan healthcare providers were fully aware and committed to the need for the applicability of the WHOHSF to the National Health Service in Libya.
[ABSTRACT]   Full text not available  [PDF]
  1,183 143 -
Ectopic ACTH syndrome caused by hepatic metastases from previously non-functional pancreatic neuroendocrine tumor
Rafik R El Mehdawi, Abdulwahab M Elbarsha, Najat Buzaid, Adel Attia, Maisoon El Hemri
July-August 2016, 8(4):120-124
Background: Pancreatic neuroendocrine tumors (NETs) are rare; representing less than 10% of all primary pancreatic tumors. The minority of these tumors are functional producing a clinical syndrome according to the hormone secreted. ACTH production by pancreatic NETs is rare and even rarer, it occurs from liver metastasis later in the course of the disease. Case Report: We report a case of a 30-year-old Libyan man who presented with Cushing's syndrome due to ectopic ACTH production from liver metastases of a pancreatic NET. The pancreatic NET was diagnosed 7 years previously when it was considered a nonfunctional at the time of diagnosis; the tumor was resected completely then. In the current presentation there was no evidence of the primary tumor but multiple liver metastases were present. Conclusions: This report highlights the fact that initially non-functional pancreatic NETs may present later with a functional hormonal syndrome either from the primary tumor itself or from its metastatic secondary tumors elsewhere.
[ABSTRACT]   Full text not available  [PDF]
  1,109 156 -
The EKG quiz: “New and old!”
Fathi Idris Ali, Yousef Darrat, Khalid Abozguia
July-August 2016, 8(4):125-126
Full text not available  [PDF]
  838 112 -
Healthcare systems framework for Libya: A challenging but achievable task!
Abdulfattah Lakhdar
July-August 2016, 8(4):127-129
Full text not available  [PDF] [CITATIONS]
  805 123 1
Applicability of the world health organization's healthcare systems framework in Libya (Authors' Reply)
Elhadi H Aburawi, Reida M El Oakley
July-August 2016, 8(4):132-133
Full text not available  [PDF]
  332 121 -
Applicability of the world health organization's healthcare systems framework in Libya (Letter)
Khalid Bel'eed-Akkari
July-August 2016, 8(4):130-131
Full text not available  [PDF]
  6 12 -