Objectives Multidrug resistance (MDR) and emergence of extended-spectrum β-lactamases (ESBLs) among uropathogenic Escherichia coli have been reported worldwide, but there was no information on the detection of blaCTX-M-15 in major teaching hospitals in Libya. The aim of the study was to investigate the occurrence of CTX-M-15 β-lactamases producers isolated from five teaching hospitals in Tripoli, Libya. Methods A total of 346 urine samples were collected from hospitalized patients in five teaching hospitals with a diagnosis of urinary tract infection (UTI). Phenotypic confirmation of ESBLs was confirmed by E-test strip; all ESBL-producing E. coli isolates were screened for the blaCTX-M-15 gene. Results The distribution of ESBL-producing E. coli varied among the five hospitals. The highest proportion was identified in Tripoli Medical Centre (67.6%). There were extremely high proportions of isolates resistant to ceftriaxone, cefepime, and ceftazidime (93.0–100.0%) among ESBL producers compared to non-ESBL producers (2.2–4.7%). MDR was detected in 22.2% of isolates. The majority of isolates (85.9%) in which blaCTX-M-15 was identified were ESBL producers. There was a correlation (p < 0.001) between expression of CTX-M-15 and resistance to ceftazidime. Conclusions The isolation of MDR ESBL-producing uropathogens expressing the CTX-M-15 gene will limit the choices clinicians have to treat their patients with UTIs. Continued surveillance and implementation of efficient infection control measures are required. arabic 17 English 94
Abdulaziz Zorgani, Abdulla Bashein(1-2017)

Opinion Cough in kids less than 6yrs old whether being with sputum i.e. wet or without i.e. dry and parental asking about any medicine stopping this symptom certainly if being dry i.e. irritating and disturbing sleep. So most studies being done on this subject proved the following: a) It is not wise to suppress cough because it is natural defense mechanism to expel infected mucus i.e. sputum out of the body and clearing the airways to improve oxygenation so never to prescribe antitussive i.e. cough suppressant. b) sputum mucolytic agents and there are many agents their purpose to liquify it and get it watery to be easy expectorated again studies proved that the best muculytic agent is Good Hydration so no need to use except where there is a mucus retention in the lungs like case of brocheictasis. c) WHO recommendation made about 6 yrs back was never to prescribe any cough medicine whether antitussive or mucolytic to kids less than 6 yrs old. Myself and since about 10 years I had not prescribed any cough suppressant to children despite of age but if kids older than 6 years old I do prescribe mucolytic agent made certainly for kids like amydramine syrup which contains antihistamine diphenhydramine and without restrictions. In kids less than 6yrs old again I do prescribe mucolytic made for kids like soolan or Amydramine pediatric syrup in trial to hit 2 birds which are sedating and antihistamine effects and satisfying anxious parents and it does work almost in all cases arabic 6 English 32
Hisham Mukhtar Alhaashimi Alrabty(5-2017)

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic kidney disorders with the incidence of 1 in 1,000 births. ADPKD is genetically heterogeneous with two genes identified: PKD1 (16p13.3, 46 exons) and PKD2 (4q21, 15 exons). Eighty five percent of the patients with ADPKD have at least one mutation in the PKD1 gene and fifteen percent of the patients have one mutation in PKD2 gene. Direct sequencing of one patient and his sequence of PKD1 gene demonstrated a missense mutation GCC----CCC substitution in exon 13 with cause change amino acid of Alanine to Proline at codon 1029. Three brothers have deletion mutation in exon 15, one patient missense mutation GGC---GCC in exon 19 which cause change amino acid of Glycine to Alanine at codon 2530. Molecular diagnostics of ADPKD relies on mutation screening of PKD1 and PKD2, which is complicated by extensive allelic heterogeneity and the presence of six highly homologous sequences of PKD1. PCR strategy was used to screen sequence variants with heteroduplex analysis and several affected individuals were discovered to have clusters of base pair substitutions in exons 13 and 19 with del 20 pb (3601-3620) in exon15. arabic 14 English 81
Refaat Tabagh, Ahmed Zaid(1-2018)