Digital Repository for Department of Medicine

Background/Aims: Patients with preexisting morbidities(e.g., malignancy, posttransplant, and heart failure) are recognized to be at increased risk of severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) infection, as well as increased risk of mortality after infection. However, there are conflicting data on the susceptibility and prevalence of infection among people living with HIV (PLWH), with higher, lower, and equal prevalence to the general population were reported. The aim of this study was to assess the prevalence of SARS‑CoV‑2 antibodies among PLWH who are attending clinical care at the Department of Infectious Diseases of Tripoli University Hospital. Materials and Methods: A cross‑sectional study conducted during the period from October 01, 2021 to December 01, 2021 at the (Department of Infectious Diseases) outpatient clinic of Tripoli University Hospital. The OnSite Coronavirus Disease 2019 IgG/IgM Rapid Test (CTK Biotech, San Diego County, California, USA) was used to determine the presence of antibodies against the spike protein of SARS‑CoV‑2 in the collected serum samples. The test results were reported as “Negative” or “Positive” as per the manufacturer’s instructions. Results: A total of 108 PLWH were included in the study. Sixty‑nine (64%) were male, and the mean age for participants was 44 years. Specific IgG/IgM antibodies for SARS‑CoV‑2 were detected in 31 individuals, representing a seroprevalence of 28.7%. Conclusions: High seroprevalence of SARS‑CoV‑2 antibodies among nonvaccinated PLWH attending clinical care at Tripoli University Hospital. They require pritorization on vaccination and boosting
Nader Shalaka(12-2021)

OBJECTIVE: The increasing prevalence of suspected cases of coronavirus disease 2019 (COVID-19) presenting to emergency departments (EDs) requires a rapid and reliable triaging tool. The diagnostic performance of chest computed tomography (CT) has yet to be validated for triaging cases in the ED. We aimed to assess the diagnostic performance of chest CT compared to GeneXpert Xpress Xpert severe acute respiratory syndrome coronavirus 2 test in rapidly diagnosing COVID-19 among patients with respiratory symptoms presenting to the ED. MATERIALS AND METHODS: This was a retrospective, single-center study at Tripoli University Hospital including cases with respiratory symptoms who underwent chest CT as well as polymerase chain reaction (PCR) testing for suspected COVID-19 between May 18 and August 18, 2020. RESULTS: A total of 1240 cases were included, among whom 570 had radiologically evident COVID-19 on chest CT (46%). Five hundred and sixty-five cases had positive PCR results (45.6%), of whom 557 had radiologically evident COVID-19 on chest CT (97.7%). The calculated accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 98%, 98.5%, 98%, 97.7%, and 98.8%, respectively, in relation to the PCR results. CONCLUSION: During the current pandemic, chest CT is a quick and reliable diagnostic tool for COVID-19 in the ED.
Nader Shalaka(11-2021)

The aim of this study was to identify nationals at risk of developing type 2 diabetes within the next 10 years in some areas across Tripoli Health Authority in Libya. In this questionnaire‐based survey, a total of 400 Libyan nationals of both genders were randomly selected from seven areas across the central area of Tripoli Health Authority (Soug El‐Juma, Zawet Dahmani, Al‐Furnaj, Ain Zara, Al‐Madena Centre, Al‐Dhahra Centre, and Noflean). All participants approached (400) completed the study and responded to the items of the survey. Based on a modified Finnish Type 2 Diabetes Risk Score test (FINDRISC), 129 (32.3%) were categorised as either at moderate or at high/very high risk of developing diabetes within the next 10 years of life. Among the 129 participants at risk, body mass index was >25 kg/m2 in 125 (96.9%) and waist circumferences were high (>88 cm for females;>102 cm for males) in almost 45% of the women and 22% of the men. We found that in the sample studied the risk of developing diabetes was clear, and there is no doubt that interventions to reduce such risk are a priority rather than a need. Diabetes has a great impact on the health of the nation and also on the future resources of the country in managing the disease and its complications; a health education/health campaign could be one good answer to tackle the problem. arabic 9 English 54
Hawa Juma El-Shareif(6-2009)

The pattern of diabetic deaths in the medical wards of Tripoli Medical Centre was retrospectively studied. During a three‐year period, 575 diabetic deaths occurred, accounting for 26.2% of all medical deaths. The mean age at death was 65.33±12.7 years. Cardiovascular disease (183 [31.8%]), cerebrovascular accidents (102 [17.7%]) and infection (83 [14.4%]) were the most common complications associated with diabetic deaths. Other causes were malignancy (10%), liver cirrhosis (5.6%), and acute diabetic complications (5%). Forty‐five (7.8%) deaths unaccountable for may be due to other unknown causes. Factors predictive of mortality, such as admission diagnosis of hyperosmolar non‐ketotic state, cerebrovascular disease, acute coronary syndromes or infection were associated with poor prognosis. Admission hyperglycaemia, old age, renal dysfunction and prior stroke were also associated with poor admission outcome. The excess mortality, mainly due to atherosclerotic complications, is potentially preventable through implementation of serious approaches to the management of cardiovascular risk factors. arabic 8 English 64
Hawa Juma El-Shareif(7-2010)

The aim of this study was to provide an overview of the risk factors for acute myocardial infarction in patients attending Tripoli Medical Centre, Libya. Records were reviewed for 622 patients with a mean age of 58.3 (SD 12.9) years. Diabetes mellitus (48.2%), hypertension (35.7%) and smoking (50.6%) were among the risk factors reported. There were 110 patients (17.7%) who died during hospitalization, mainly suffering cardiogenic shock (48.0%). The rate of use of thrombolytic therapy was low in patients who were female (40.4% versus 58.4% for males), older age (31.6% for those > 85 years versus 63.3% for patients < 55 years), diabetics (45.3% versus 62.0% for non-diabetic patients) and hypertensives (47.3% versus 57.8% for non-hypertensive patients). Prevention strategies should be implemented in order to improve the long-term prognosis and decrease overall morbidity and mortality from coronary artery disease in Libyan patients. arabic 20 English 112
Hawa Juma El-Shareif(4-2012)

This study aimed to identify areas of deficient knowledge among hospital nurses regarding diabetes management; the ultimate goal was to improve the quality of care for people with diabetes who are admitted to hospital for other medical reasons. Diabetes-related knowledge was assessed in 116 nurses using a 66-item questionnaire; the mean total score was 48.5±15.1. Knowledge was highest for nurses working in paediatrics (62.0±5.5; P
Hawa Juma El-Shareif(7-2013)

Objectives: The objective of this study is to study the demographic, clinicopathological features, and geographical distribution of differentiated thyroid cancer (DTC) among Libyan patients referred from all parts of the country to the nuclear medicine department, for radioactive iodine (RAI) therapy.Materials and Methods: Retrospective review of medical records of 265 patients with differentiated thyroid carcinoma (DTC) referred to RAI therapy in the Nuclear Medicine Branch‑Tripoli Medical Center, in the period from May 2005 to October 2010. The data analyzed included sex, age at the time of diagnosis, the city of residence, pathological diagnosis, the extent of disease, and types of treatment.Results: There were 225 (84.9%) females and 40 (15.1%) males giving a sex ratio of 5.6:1. The mean age of males at diagnosis was 51.2 ± 14.8 (range 24–78) years and  the  mean age  of  the  females was  44.6 ± 15.6 (range 10–95) years. Two  hundred and  twenty‑three (84.2%) had  papillary thyroid cancer (PTC), 31 (11.7%) had  follicular thyroid cancer, 3 (1.1%) had  Hurthle cell  thyroid cancer, and  2 (0.8%) had follicular‑insular thyroid cancer. About 43 (16.2%) had  a  history of  multinodular goiter, and  3 (1.1%) Hashimoto’s thyroiditis. From data  collected, cervical lymph node metastases were found in 45 (17.0%), and distal metastases in 27 (10.2%).Conclusions: PTC was the most common type of DTC. DTC was more common among females. The current study showed that the disease tends to occur at an older age, and with less cervical lymph node metastases than previously reported.
Hawa Juma El-Shareif(3-2018)

Background: The metabolic syndrome (MS) is defined as a cluster of cardiovascular risk factors, including central obesity, dysglycemia, hypertension (HPN), elevated triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C). MS increases the risk of cardiovascular disease and all-cause mortality. Objective: This study aims to estimate the prevalence of MS and its components among nondiabetic Libyan females using the definition proposed by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Methods: A total of 122 randomly selected nondiabetic Libyan females were included in the study. Detailed medical history was obtained from all participants. Blood pressure, weight, height, waist and hip circumference were measured. Body mass index and waist–hip ratio were calculated. Fasting blood glucose (FBG) and lipid profile were collected. Standard oral glucose tolerance test with 75 GM glucose was performed. The MS was defined by ATP III and International Diabetes Federation criteria. Results: According to NCEP definition, the prevalence of the MS in the study group was 42.6%. The most common component was abdominal obesity (67.2%). FBG was ≥ 100 mg/dl in 47.5%. The prevalence of both HPN and low HDL-C was 45.9%. About 26.2% of the participants have their TG ≥ 150 mg/dl; all were MS patients. Conclusions: The prevalence of MS and cardiovascular risk factors were high among Libyan females. Public health authorities and health-care providers should implement strategies for prevention, screening, and management of cardiovascular risk factors to reduce the burden of its potential complications
Hawa Juma El-Shareif(4-2018)