المستودع الرقمي لـكلية الطب البشري

Abstract 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. arabic 18 English 100
Nabil A Alagili(7-2016)

Despite the relative abundance of sunny weather, surprisingly, there is increasing evidence that vitamin D deficiency is extremely prevalent in females of reproductive age in Middle East countries. There is also increasing interest in the non-classical roles of vitamin in health and disease including its relation to incidence of gestational diabetes, its impact on glycaemic control in diabetes mellitus, and its association with some complications of pregnancy like preeclampsia. The objective of this study was to estimate the prevalence of Vitamin D deficiency in pregnant diabetic patients in west Libya and analyse potential links to socioeconomic and cultural factors. This is a cross sectional observational study. Random plasma was collected form expected mothers attending the Antenatal Diabetes Clinic at Tripoli’s Main Maternity Hospital. Demographics and socioeconomic and cultural factors were recorded at the same time. Samples were analysed for vitamin D level and biochemical screening panel. Vitamin D level was obtained from 160 patients (mean age 35 years). Over all 95 % of the study population had vitamin D levels below normal (defined as vitamin D level of < 20 ng/mL). Results were subcategorised into severe deficiency ( 30 ng/ml, only 1.3%, 2 patients). All patients were taking daily vitamin D Supplements at a dose of 400 IU as per hospital policy. Vitamin D deficiency is extremely prevalent in pregnant diabetic patients in Libya. There is no clear association with socioeconomic risk factors like employment, type of accommodation or geographic distribution. However, most of the study population had life style characterized by minimal exposure to direct sun arabic 11 English 70
G Murad, A Bashein(1-2019)

Background and Aims: Despite the well‑known association between human papillomavirus (HPV) and cervical cancer, yet there are no available data concerning the prevalence of HPV and its type distribution among Libyan women. The aim of this study was to investigate the prevalence of the most common high‑risk HPV types 16 and 18 among Libyan women in Tripoli and to compare it with the cytological findings of the cervix. Methods: A total of 132 cervical samples were collected from women who sought medical attention at the gynecology outpatient clinic of the Tripoli University Hospital and other gynecology private clinics in Tripoli region. Cervical cytological status was classified according to the Bethesda System 2014. Quantitative polymerase chain reaction was used to facilitate the specific detection of HPV types 16 and/or 18. Results: The cytopathological examination showed that 92.4% of women had normal cervical cytology (n = 122/132) and 7.5% (n = 10/132) of them had cervical lesions. The overall prevalence of the most common oncogenic HPV types was 4.5%, as only six samples (n = 6/132) were confirmed of harboring HPV‑DNA. Concerning the cytological status of the cervix, HPV‑DNA was not found (0%) in women with a normal cervix, and it was present in 60% of women with cervical lesions. The high‑risk HPV type 16 was the exclusive type among our all positive samples, with no detection of HPV type 18 among all our recruited subjects. Conclusion: Even though our findings showed a low overall prevalence of high‑risk HPV types among Libyan women, the burden of HPV 16 among women with cervical lesions highlights the need to raise attention toward expanding research about HPV and adopt measures to prevent cervical cancer by vaccination and national screening program. The introduction of HPV‑DNA testing in cervical cancer management will greatly benefit early‑stage HPV detection and help prevent cervical lesions from progression to cancer. arabic 15 English 81
H Alzaquzi, A Bashein(1-2019)

Bulgular: 791 çocuktan (421 erkek, 370 kız, ortalama yaş 6.5) alınan örnekler test edildi. Tüm çocuklar hayatlarının ilk iki yılında 4 doz tam hücreli boğmaca aşısı ile aşılanmıştı. Yakın zamanda gerçekleşen ve gerçekleşmeyen boğmaca enfeksiyonu sıklığı sırasıyla% 4.8 ve% 2.5 idi. Çocukların% 76.1’i tespit edilemeyecek düzeyde IgG’ye sahipti. Sonuç: Çalışma boğmaca enfeksiyonun okula başlayan çocuklar arasında sık olarak geçirildiğini göstermiştir. Bu artış, okula başlama yaşındaki çocukların% 76.1’inde serumda boğmacaya karşı antikor düzeyinin tespit edilemeyecek düzeyde olmasının dolaylı bir sonucu olması ile açıklanmıştır. arabic 26 English 62
Suleiman Abusrewil, Abdulla Bashein, (1-2021)

Measles, Mumps ,and rubella (MMR) are serious diseases that can lead potentially to disability and death. The study aimed to determine seroprevalence rates of antibody levels against MMR among Libyan children at school entry. This was a cross sectional study undertaken in Tripoli, from August to September 2016. Children of school-entry age (> 5 to ≤ 7 years) were randomly recruited at vaccination centers. Sera were tested for antibodies againstMMR. Data analyzed by SPSS program version 20. Out of 546 children, 290 were males. IgG antibodies against measles, mumps, and rubella were positive in 513 (94%), 436 (80%), 538 (98.5%) children, respectively. Seropositivity rates in Libyan children at school entry is protective and this is similar in so many other studies. This indicates that MMR vaccine program is effective in strengthening herd immunity in the Libyan community. arabic 19 English 111
Mohamed Abugalia, A Bashein(1-2021)

Alkaline phosphatase (ALP) enzyme level, which is routinely measured at clinical laboratories, increases in end-stage renal disease (ESRD) and hepatitis patients. This study investigated the difference in ALP level among ESRD and hepatitis patients. ALP level was measured in sera of patients suffering from ESRD, HCV and HBV infections, as well as patients suffering from comorbidity of these diseases, then the obtained values of ALP level were statistically compared to a control group. The results of three-Way ANOVA revealed that the mean of ALP level increased significantly (P-value< 0.05) in all types of diseases compared to the control group, with the highest increase in case of ESRD patients infected with Hepatitis B and C. Also, it was found that the interaction of group-gender significantly (P-value< 0.05) altered ALP level in patients suffering from HCV or HBV infections, while the interaction of group-age, gender-age, group-gender-age were found not to significantly alter it. In conclusion, ESRD patients with HBV/HCV coinfection may have a higher risk of liver-related morbidity and mortality than ESRD or HBV or HCV patients. arabic 25 English 103
HA Alemam, A Bashein(1-2020)

Factor V Leiden G1691A (FVL) and Factor II prothrombin G20210A (PGM) mutations are the leading causes of thrombophilia. In this study, we have investigated the prevalence of the FVL G1691A and PGM G20210A single nucleotide polymorphisms (SNPs) among Libyan deep vein thrombosis (DVT) and myocardial infarction (MI) patients. SNP genotyping was performed using high-resolution melt analysis (HRM) and DNA sequencing. Biochemical parameters conducted on 112 males and 93 females showed no significant difference in means between the control group and the deep vein thrombosis and myocardial infarction groups. For Factor V Leiden, 40 samples were genotyped. Of the 40 samples, 6 (15.0%) of them were heterozygous and no one was homozygous. As for Factor II SNP, 59 samples were genotyped and only 2 (3.3%) were heterozygous. All the heterozygous samples showed 100% concordance between the HRM-PCR and DNA sequence analysis. Our study showed, for the first time, that both the FVL and PGM mutations are present among Libyan DVT and MI patients and that the FVL mutation is significantly associated with DVT but not with MI. However, our results do not support the association of PGM G20210A mutation with DVT or MI. arabic 18 English 117
Abdulghani Msalati, Abdulla Bashein, Murad Ghrew, Khaled Sedaa, Abushawashi Ali, Ahmed Zaid, (1-2021)

Fungi are a huge source of unexplored bioactive compounds. Owing to their biological activities, several fungi have shown commercial application in the health industry. Tuber aestivum Vittad. is one such edible fungi with an immense scope for practical biological applications. In the present study, the anti-angiogenic activity of petroleum ether and ethanol extracts of T. aestivum was investigated using the chick chorioallantoic membrane assay and compared to the positive controls silibinin and lenalidomide. Both the extracts showed a dose-dependent anti-angiogenic response. The extracts were also assessed for their anti-inflammatory potential by lipoxygenase-inhibition assay. The IC50 values for LOX inhibition assay, computed by the Boltzmann plot, were 368.5, 147.3 and 40.2 μg/mL, for the petroleum ether extract, ethanol extract, and the positive control ascorbic acid, respectively. The ethanol extract of T. aestivum showed superior anti-angiogenic and anti-inflammatory activity than the petroleum ether extract. Compositional investigation of the extracts by GC–MS revealed the presence of various bioactive compounds. The compounds were correlated to their anti-angiogenic and antiinflammatory activity based on a meticulous literature search. arabic 25 English 145
Sandesh J. Marathe, Abdulla Bashein, (1-2020)